PMID- 21910821
OWN - NLM
STAT- MEDLINE
DCOM- 20120313
LR  - 20230829
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
VI  - 9
IP  - 11
DP  - 2011 Nov
TI  - Comparison of enoxaparin and unfractionated heparin in endovascular interventions 
      for the treatment of peripheral arterial occlusive disease: a randomized 
      controlled trial.
PG  - 2159-67
LID - 10.1111/j.1538-7836.2011.04501.x [doi]
AB  - BACKGROUND: Although unfractionated heparin (UFH) is an effective antithrombotic 
      agent in endovascular interventions for the treatment of peripheral occlusive 
      arterial disease (PAOD), it produces a highly variable anticoagulant response. 
      Intravenous (i.v.) enoxaparin might be an effective and safe alternative. 
      PATIENTS AND METHODS: In a prospective, open-label, randomized, single-center 
      trial, 210 patients with PAOD (Fontaine stage IIb to IV) were randomly assigned 
      in a 1 (UFH): 2 (enoxaparin) fashion to receive an i.v. bolus of 60 units UFH per 
      kg body weight or 0.5 mg enoxaparin per kg body weight, respectively, before 
      endovascular intervention. The primary composite endpoint assessed the clinical 
      performance of enoxaparin by comparing the peri-interventional rate of 
      thromboembolia/occlusion (efficacy) of endovascularly reconstructed areas, of 
      bleeding according to the Global Utilization of Streptokinase and t-PA for 
      Occluded Coronary Arteries (GUSTO) criteria (safety) and of any necessary 
      re-intervention for any percutaneous transluminal angioplasty (PTA)-related 
      bleeding. The secondary endpoint evaluated anti-factor (F)Xa levels during 
      intervention. RESULTS: The primary composite endpoint showed a better performance 
      of enoxaparin (10.5% vs. 2.5% absolute difference - 8.0%; P < 0.05). The 
      concomitant use of acetylsalicylic acid (ASA) significantly (P < 0.05) increased 
      the risk of a complication in the UFH group, but not in the enoxaparin group. 
      Within 15 min, anti-Xa levels were reached by 63.7% of patients treated with 
      enoxaparin and only by 39.1% with UFH. CONCLUSION: Enoxaparin has a better 
      performance than UFH in endovascular interventions for the treatment of PAOD. In 
      patients with concomitant use of ASA, the risk of complications with UFH 
      increases significantly compared with enoxaparin.
CI  - (c) 2011 International Society on Thrombosis and Haemostasis.
FAU - Duschek, N
AU  - Duschek N
AD  - Department of Vascular and Endovascular Surgery, Wilhelminenspital, Vienna Center 
      for Public Health, Department of Epidemiology, Medical University of Vienna, 
      Vienna, Austria. nduschek@me.com
FAU - Vafaie, M
AU  - Vafaie M
FAU - Skrinjar, E
AU  - Skrinjar E
FAU - Hirsch, K
AU  - Hirsch K
FAU - Waldhor, T
AU  - Waldhor T
FAU - Hubl, W
AU  - Hubl W
FAU - Bergmayr, W
AU  - Bergmayr W
FAU - Knoebl, P
AU  - Knoebl P
FAU - Assadian, A
AU  - Assadian A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Enoxaparin)
RN  - 0 (Factor Xa Inhibitors)
RN  - 9005-49-6 (Heparin)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aged
MH  - Arterial Occlusive Diseases/complications/*drug therapy/surgery
MH  - Aspirin/therapeutic use
MH  - Drug Therapy, Combination/adverse effects
MH  - Endothelium, Vascular
MH  - Enoxaparin/*administration & dosage/adverse effects
MH  - Factor Xa Inhibitors
MH  - Female
MH  - Hemorrhage
MH  - Heparin/*administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/complications/*drug therapy/surgery
MH  - Treatment Outcome
EDAT- 2011/09/14 06:00
MHDA- 2012/03/14 06:00
CRDT- 2011/09/14 06:00
PHST- 2011/09/14 06:00 [entrez]
PHST- 2011/09/14 06:00 [pubmed]
PHST- 2012/03/14 06:00 [medline]
AID - S1538-7836(22)07449-9 [pii]
AID - 10.1111/j.1538-7836.2011.04501.x [doi]
PST - ppublish
SO  - J Thromb Haemost. 2011 Nov;9(11):2159-67. doi: 10.1111/j.1538-7836.2011.04501.x.