PMID- 21315215
OWN - NLM
STAT- MEDLINE
DCOM- 20110331
LR  - 20171116
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 161
IP  - 2
DP  - 2011 Feb
TI  - Certoparin versus unfractionated heparin to prevent venous thromboembolic events 
      in patients hospitalized because of heart failure: a subgroup analysis of the 
      randomized, controlled CERTIFY study.
PG  - 322-8
LID - 10.1016/j.ahj.2010.10.005 [doi]
AB  - BACKGROUND: Despite the elevated risk for developing venous thromboembolic events 
      in patients with heart failure, there are no randomized, double-blind, controlled 
      trial data on the comparison of low-molecular-weight heparin with unfractionated 
      heparin (UFH) in this patient population. METHODS: This was a subgroup analysis 
      of the CERTIFY trial, which included 3,239 nonsurgical, acutely ill medical 
      patients 70 years or older. Patients were randomized to receive 3,000-U anti-Xa 
      certoparin once daily or 5,000-IU UFH 3 times a day. The analysis was performed 
      on a subgroup of 542 patients diagnosed with heart failure at hospital admission. 
      RESULTS: Patients with heart failure differed from patients without heart failure 
      in that they were more likely using antiplatelets (67.2% vs 48.9%; P < .0001) and 
      had a lower glomerular filtration rate (8.0% vs 5.5%; </= 30 mL/min per 1.73 m(2); P 
      = .0232). Thromboembolic risk was comparable except for a higher incidence of 
      distal deep venous thrombosis (DVT) in patients with heart failure (10.80% vs 
      7.26%; P = .0144). Within the heart failure population, patient characteristics 
      were comparable between randomized treatment groups. The incidence of the primary 
      end point (proximal DVT, symptomatic nonfatal pulmonary embolism, and venous 
      thromboembolism-related death combined) was numerically, slightly smaller with 
      certoparin (3.78% vs 4.74% with UFH; odds ratio 0.79, 95% CI 0.32-1.94), and the 
      incidence of major bleeding was 0.72% with certoparin versus 0.38% with UFH. 
      CONCLUSIONS: Patients hospitalized for heart failure are at high risk for 
      developing distal DVT and bleeding complications compared with acutely ill 
      medical patients without heart failure. Within the heart failure population, the 
      observed differences in prophylactic efficacy between 3,000-U anti-Xa certoparin 
      once daily and 5,000-IU UFH 3 times a day were similar to those observed in the 
      overall study population; this suggests that certoparin might be at least as 
      effective as UFH also in this subgroup. There were no relevant differences in 
      bleeding risk or frequency of adverse events.
CI  - Copyright (c) 2011 Mosby, Inc. All rights reserved.
FAU - Tebbe, Ulrich
AU  - Tebbe U
AD  - Klinikum Lippe-Detmold, Detmold, Germany. ulrich.tebbe@klinikum-lippe.de
FAU - Schellong, Sebastian M
AU  - Schellong SM
FAU - Haas, Sylvia
AU  - Haas S
FAU - Gerlach, Horst Eberhard
AU  - Gerlach HE
FAU - Abletshauser, Claudia
AU  - Abletshauser C
FAU - Sieder, Christian
AU  - Sieder C
FAU - Bramlage, Peter
AU  - Bramlage P
FAU - Riess, Hanno
AU  - Riess H
LA  - eng
SI  - ClinicalTrials.gov/NCT00451412
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - V72OT3K19I (certoparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Double-Blind Method
MH  - Female
MH  - Heart Failure/*complications/therapy
MH  - Heparin/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - Venous Thromboembolism/*etiology/*prevention & control
EDAT- 2011/02/15 06:00
MHDA- 2011/04/01 06:00
CRDT- 2011/02/15 06:00
PHST- 2010/07/02 00:00 [received]
PHST- 2010/10/01 00:00 [accepted]
PHST- 2011/02/15 06:00 [entrez]
PHST- 2011/02/15 06:00 [pubmed]
PHST- 2011/04/01 06:00 [medline]
AID - S0002-8703(10)00905-1 [pii]
AID - 10.1016/j.ahj.2010.10.005 [doi]
PST - ppublish
SO  - Am Heart J. 2011 Feb;161(2):322-8. doi: 10.1016/j.ahj.2010.10.005.