PMID- 21658750
OWN - NLM
STAT- MEDLINE
DCOM- 20120322
LR  - 20171116
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 128
IP  - 5
DP  - 2011 Nov
TI  - Certoparin versus UFH to prevent venous thromboembolic events in the very elderly 
      patient: an analysis of the CERTIFY study.
PG  - 417-21
LID - 10.1016/j.thromres.2011.05.002 [doi]
AB  - INTRODUCTION: There is an exponential rise of thromboembolic risk with age 
      because of co-morbidities, immobility and pharmacotherapy. We aimed to 
      investigate the benefits and risks of heparin prophylaxis in very elderly 
      patients >/=80 years and the type of heparin used in a subgroup analysis of the 
      CERTIFY trial. PATIENTS/METHODS: 3,239 patients were randomized to 3,000 U aXa 
      o.d. certoparin or 5,000 IU t.i.d. unfractionated heparin (UFH) for 8-20 days. 
      RESULTS: Patients >/=80 years (n=1,365) were more likely to be female, had a lower 
      mean bodyweight, were more frequently using antiplatelets and had a GFR below 30 
      ml/min/1.73 m(2) more often than patients <80 years (n=1,875). The combined 
      endpoint of proximal DVT, symptomatic non-fatal PE and VTE related death was 
      experience by 5.26% of patients >/=80 years versus 3.51% in younger patients (OR 
      1.53; 95%CI 1.05-2.21; p=0.03). There were no significant differences in both 
      minor (OR 1.11; 95%CI 0.75-1.62) and major (OR 2.53; 95%CI 0.93-6.86) bleeding 
      risks. Certoparin and UFH were equally effective in reducing thromboembolic risk 
      in either age group. The risk of any (OR 0.45; 95%CI 0.26-0.79) and minor 
      bleeding (OR 0.42; 95%CI 0.23-0.78) was reduced with certoparin in the very 
      elderly only. There were more adverse events in elderly patients (OR 1.26; 95%CI 
      1.1-1.46), but rates were otherwise comparable. CONCLUSIONS: The analysis 
      confirmed the increased thromboembolic risk in very elderly patients, but 
      demonstrated no increased bleeding risk. Certoparin and UFH were equally 
      effective and safe with a reduced risk of minor bleeding complications with 
      certoparin in the very elderly.
CI  - Copyright (c) 2011 Elsevier Ltd. All rights reserved.
FAU - Schellong, S M
AU  - Schellong SM
AD  - Klinikum Friedrichstadt, Dresden, Germany. schellong-se@khdf.de
FAU - Gerlach, H-E
AU  - Gerlach HE
FAU - Tebbe, U
AU  - Tebbe U
FAU - Haas, S
AU  - Haas S
FAU - Melzer, N
AU  - Melzer N
FAU - Abletshauser, C
AU  - Abletshauser C
FAU - Sieder, C
AU  - Sieder C
FAU - Bramlage, P
AU  - Bramlage P
FAU - Riess, H
AU  - Riess H
FAU - Bauersachs, R
AU  - Bauersachs R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20110611
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
RN  - V72OT3K19I (certoparin)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants
MH  - Chemoprevention
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/adverse effects/*therapeutic use
MH  - Humans
MH  - Male
MH  - Odds Ratio
MH  - Premedication
MH  - Risk
MH  - Thromboembolism/etiology/*prevention & control
MH  - Venous Thrombosis/etiology/prevention & control
EDAT- 2011/06/11 06:00
MHDA- 2012/03/23 06:00
CRDT- 2011/06/11 06:00
PHST- 2011/03/07 00:00 [received]
PHST- 2011/04/26 00:00 [revised]
PHST- 2011/05/02 00:00 [accepted]
PHST- 2011/06/11 06:00 [entrez]
PHST- 2011/06/11 06:00 [pubmed]
PHST- 2012/03/23 06:00 [medline]
AID - S0049-3848(11)00227-1 [pii]
AID - 10.1016/j.thromres.2011.05.002 [doi]
PST - ppublish
SO  - Thromb Res. 2011 Nov;128(5):417-21. doi: 10.1016/j.thromres.2011.05.002. Epub 
      2011 Jun 11.