PMID- 27265806
OWN - NLM
STAT- MEDLINE
DCOM- 20170919
LR  - 20180416
IS  - 1875-9114 (Electronic)
IS  - 0277-0008 (Linking)
VI  - 36
IP  - 7
DP  - 2016 Jul
TI  - Safety and Efficacy of High-Dose Unfractionated Heparin for Prevention of Venous 
      Thromboembolism in Overweight and Obese Patients.
PG  - 740-8
LID - 10.1002/phar.1775 [doi]
AB  - STUDY OBJECTIVE: To determine the safety and efficacy of high-dose subcutaneous 
      unfractionated heparin (UFH) for prevention of venous thromboembolism (VTE) in 
      overweight and obese patients. DESIGN: Single-center retrospective observational 
      cohort study. SETTING: Large academic tertiary care medical center. PATIENTS: A 
      total of 1335 adults who weighed more than 100 kg on admission and received 
      either subcutaneous UFH 7500 units every 8 hours (751 patients [high-dose group]) 
      or 5000 units every 8 hours (584 patients [low-dose group]) for VTE prophylaxis 
      during their hospitalization between January 1, 2013, and August 31, 2014. 
      MEASUREMENTS AND MAIN RESULTS: The incidences of VTE and bleeding complications 
      were assessed in each group. Each group was further divided into four groups 
      based on their body mass index (BMI): overweight (BMI 25-29.9 kg/m(2) ), obese 
      class I (BMI 30-34.9 kg/m(2) ), obese class II (BMI 35-39.9 kg/m(2) ), and obese 
      class III (BMI >/= 40 kg/m(2) ). The incidence of VTE was similar for patients in 
      the high-dose group versus those in the low-dose group for all BMI categories. 
      Bleeding complications were significantly higher for patients in the high-dose 
      group. The proportion of patients with at least a 2-g/dl hemoglobin drop from 
      admission was higher in patients in the high-dose groups in obese classes II and 
      III: obese class II, 46 (30%) of 152 patients in the high-dose group versus 30 
      (18%) of 171 patients in the low-dose group (p<0.01); obese class III, 109 (25%) 
      of 432 patients in the high-dose group versus 31 (12%) of 249 patients in the 
      low-dose group (p<0.01). In addition, the proportion of patients who received at 
      least 2 units of packed red blood cell transfusion was significantly higher in 
      patients in the high-dose group who were in obese class III: 47 (11%) of 432 in 
      the high-dose group versus 13 (5%) of 249 in the low-dose group (p<0.01). 
      CONCLUSION: Administering a higher dose of heparin to patients weighing more than 
      100 kg may not impart additional efficacy in reducing the incidence of VTE. 
      However, it may increase the risk for bleeding.
CI  - (c) 2016 Pharmacotherapy Publications, Inc.
FAU - Joy, Mishna
AU  - Joy M
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Tharp, Eileen
AU  - Tharp E
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Hartman, Heather
AU  - Hartman H
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Schepcoff, Sara
AU  - Schepcoff S
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Cortes, Jennifer
AU  - Cortes J
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Sieg, Adam
AU  - Sieg A
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Mariski, Mark
AU  - Mariski M
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Lee, Yeunju
AU  - Lee Y
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Murphy, Meghan
AU  - Murphy M
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Ranjbar, Ghazaleh
AU  - Ranjbar G
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Sharaf, Sherouk
AU  - Sharaf S
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Yau, Gin
AU  - Yau G
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
FAU - Choi, Huimahn Alex
AU  - Choi HA
AD  - Department of Neurosurgery & Neurology, University of Texas Medical School, 
      Houston, Texas.
FAU - Samuel, Sophie
AU  - Samuel S
AD  - Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas.
LA  - eng
PT  - Journal Article
DEP - 20160629
PL  - United States
TA  - Pharmacotherapy
JT  - Pharmacotherapy
JID - 8111305
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Body Mass Index
MH  - Female
MH  - Heparin/adverse effects/*therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications
MH  - Overweight/*complications
MH  - Retrospective Studies
MH  - Venous Thromboembolism/*prevention & control
OTO - NOTNLM
OT  - heparin
OT  - obesity
OT  - overweight
OT  - risk factors
OT  - venous thromboembolism
EDAT- 2016/06/07 06:00
MHDA- 2017/09/20 06:00
CRDT- 2016/06/07 06:00
PHST- 2016/06/07 06:00 [entrez]
PHST- 2016/06/07 06:00 [pubmed]
PHST- 2017/09/20 06:00 [medline]
AID - 10.1002/phar.1775 [doi]
PST - ppublish
SO  - Pharmacotherapy. 2016 Jul;36(7):740-8. doi: 10.1002/phar.1775. Epub 2016 Jun 29.