PMID- 21184996
OWN - NLM
STAT- MEDLINE
DCOM- 20110408
LR  - 20131121
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 107
IP  - 4
DP  - 2011 Feb 15
TI  - Comparison of the effectiveness and safety of low-molecular weight heparin versus 
      unfractionated heparin anticoagulation after heart valve surgery.
PG  - 591-4
LID - 10.1016/j.amjcard.2010.10.020 [doi]
AB  - Although unfractionated heparin (UFH) is used routinely after heart valve surgery 
      at many institutions, cardiovascular surgery patients have a particularly high 
      risk for developing heparin-induced thrombocytopenia (HIT). The aim of this study 
      was to compare the efficacy and safety of low-molecular-weight heparin (LMWH) or 
      UFH after heart valve surgery by conducting a retrospective evaluation of 
      consecutive cardiovascular surgery patients in whom the LMWH dalteparin (n = 100) 
      was used as the postoperative anticoagulant. This group was compared to an 
      earlier group of patients who received UFH (n = 103). The main outcomes included 
      the efficacy of the anticoagulant regimens (determined by the incidence of valve 
      thrombosis, arterial thromboembolic events, and venous thromboembolic events) and 
      the safety (determined by major bleeding, HIT, thrombotic events in HIT-positive 
      cases, and death). Overall, there were for fewer thrombotic events in the 
      LMWH-treated group (4% vs 11%, p = 0.11). There was a higher rate of bleeding 
      events in the UFH-treated group (10% vs 3%, p = 0.08). Six patients in the 
      UFH-treated group developed HIT, 4 of whom had thrombotic events (HIT with 
      thrombosis). In the LMWH-treated group, 3 patients developed HIT, 1 of whom had 
      HIT with thrombosis. In conclusion, in this study, an LMWH regimen after heart 
      valve surgery was effective and safe, with fewer thrombotic, bleeding, HIT, and 
      HIT with thrombosis events.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Bucci, Claudia
AU  - Bucci C
AD  - Department of Pharmacy, University of Toronto, Ontario, Canada. 
      claudia.bucci@sunnybrook.ca
FAU - Geerts, William H
AU  - Geerts WH
FAU - Sinclair, Andrew
AU  - Sinclair A
FAU - Fremes, Stephen E
AU  - Fremes SE
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20101222
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Dalteparin/therapeutic use
MH  - Female
MH  - Heart Valve Diseases/complications/*surgery
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/adverse effects/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Thromboembolism/etiology/*prevention & control
MH  - Treatment Outcome
EDAT- 2010/12/28 06:00
MHDA- 2011/04/09 06:00
CRDT- 2010/12/28 06:00
PHST- 2010/07/15 00:00 [received]
PHST- 2010/10/11 00:00 [revised]
PHST- 2010/10/11 00:00 [accepted]
PHST- 2010/12/28 06:00 [entrez]
PHST- 2010/12/28 06:00 [pubmed]
PHST- 2011/04/09 06:00 [medline]
AID - S0002-9149(10)02103-X [pii]
AID - 10.1016/j.amjcard.2010.10.020 [doi]
PST - ppublish
SO  - Am J Cardiol. 2011 Feb 15;107(4):591-4. doi: 10.1016/j.amjcard.2010.10.020. Epub 
      2010 Dec 22.