PMID- 29276299
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 52
IP  - 9
DP  - 2017 Oct
TI  - Safety and Efficacy of Enoxaparin Compared With Unfractionated Heparin for Venous 
      Thromboembolism Prophylaxis in Hemodialysis Patients.
PG  - 623-627
LID - 10.1177/0018578717724799 [doi]
AB  - Background: Enoxaparin, a low-molecular-weight heparin approved for prophylaxis 
      in patients at risk for venous thromboembolism (VTE), offers several advantages 
      compared with unfractionated heparin (UFH). Enoxaparin is primarily excreted 
      through renal elimination and is currently not recommended in patients receiving 
      hemodialysis (HD) due to potential increased bleeding complications. To date, 
      there are limited safety and efficacy data supporting the use of enoxaparin in 
      this patient population for VTE prophylaxis. Objective: The aim of this study was 
      to compare the safety and efficacy of enoxaparin with UFH for deep venous 
      thromboembolism (DVT) prophylaxis in medically ill HD patients. Methods and 
      Results: This retrospective cohort study examined medically ill patients who 
      received HD and were concomitantly prescribed enoxaparin or UFH for at least 2 
      consecutive days for VTE prophylaxis. A total of 225 patients (150 received UFH 
      and 75 received enoxaparin) were evaluated in chronological order. The primary 
      outcome was a composite of major, clinically relevant nonmajor, and minor 
      bleeding based on International Society on Thrombosis and Haemostasis bleeding 
      definitions. The secondary outcome was the occurrence of a confirmed thrombotic 
      event. Baseline characteristics were similar between the cohorts. One patient in 
      each cohort had a documented bleed (UFH = 0.7%, enoxaparin = 1.3%, P > .05) 
      during the admission assessed; however, neither bleed was related to the 
      prophylactic agent utilized. No patients developed a VTE during the index 
      hospitalization. Conclusions: This study demonstrates that enoxaparin may be as 
      safe and effective as UFH for VTE prophylaxis in medically ill patients receiving 
      HD.
FAU - Green, Melissa S
AU  - Green MS
AD  - Missouri Baptist Medical Center, St. Louis, MO, USA.
FAU - Tellor, Katie B
AU  - Tellor KB
AD  - St. Louis College of Pharmacy, MO, USA.
FAU - Buckallew, Amanda R
AU  - Buckallew AR
AD  - Missouri Baptist Medical Center, St. Louis, MO, USA.
LA  - eng
PT  - Journal Article
DEP - 20170811
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC5735731
OTO - NOTNLM
OT  - dialysis
OT  - enoxaparin
OT  - heparin
OT  - prophylaxis
OT  - venous thromboembolism
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/12/26 06:00
MHDA- 2017/12/26 06:01
PMCR- 2018/10/01
CRDT- 2017/12/26 06:00
PHST- 2017/12/26 06:00 [entrez]
PHST- 2017/12/26 06:00 [pubmed]
PHST- 2017/12/26 06:01 [medline]
PHST- 2018/10/01 00:00 [pmc-release]
AID - 10.1177_0018578717724799 [pii]
AID - 10.1177/0018578717724799 [doi]
PST - ppublish
SO  - Hosp Pharm. 2017 Oct;52(9):623-627. doi: 10.1177/0018578717724799. Epub 2017 Aug 
      11.