PMID- 31203501
OWN - NLM
STAT- MEDLINE
DCOM- 20200420
LR  - 20200420
IS  - 1179-187X (Electronic)
IS  - 1175-3277 (Linking)
VI  - 19
IP  - 6
DP  - 2019 Dec
TI  - Comparison of Venous Thromboembolism Prophylactic Measures Post Coronary Artery 
      Bypass Graft Surgery.
PG  - 589-595
LID - 10.1007/s40256-019-00354-4 [doi]
AB  - BACKGROUND: There is considerable debate surrounding venous thromboembolism (VTE) 
      prophylaxis in patients post coronary artery bypass grafting (CABG) procedures. 
      The American College of Chest Physicians guidelines report weak recommendations 
      for starting VTE prophylaxis, but provide no specific guidance regarding timing 
      or preferred prophylactic agent. METHODS: This retrospective cohort study was 
      designed to compare outcomes of post-cardiac surgery patients admitted to the 
      cardiovascular intensive care unit (ICU) who received subcutaneous unfractionated 
      heparin (UFH), with those who received subcutaneous enoxaparin for VTE 
      prophylaxis. Between January 2013 and September 2017, 1085 patients were 
      identified, and, after propensity score matching, 850 patients were selected for 
      analysis. The primary outcomes were postoperative VTE and the occurrence of 
      bleeding events up to 30 days postoperatively. Secondary outcomes included chest 
      tube output, days mechanically ventilated, ICU length of stay, total hospital 
      length of stay, and 30-day readmission rates. RESULTS: During the study period, 
      rates of 2.03% for VTE events and 1.38% for bleeding events were reported in the 
      entire cohort. After matching, the rates of VTE events (2.12% vs. 1.41%, 
      p = 0.43) and bleeding events (1.18% vs. 0.94%, p = 1.00) were more frequent in 
      the heparin group versus the enoxaparin group; these differences were not 
      statistically significant. However, we did find a statistically significant 
      increase in several secondary endpoints, including chest tube output, days 
      mechanically ventilated, ICU length of stay, and total hospital length of stay, 
      within the heparin cohort. Bleeding rates were similar to those previously 
      published, despite the early initiation of VTE prophylaxis. CONCLUSIONS: We 
      report no statistical difference in the rates of VTE or bleeding between chemical 
      agents, but our results suggest enoxaparin may be a preferred agent over UFH.
FAU - Wilsey, H Andrew
AU  - Wilsey HA
AUID- ORCID: 0000-0003-3672-1929
AD  - University of Kentucky HealthCare, Lexington, KY, USA. handreww@buffalo.edu.
FAU - Pandya, Komal
AU  - Pandya K
AD  - University of Kentucky HealthCare, Lexington, KY, USA.
AD  - University of Kentucky School of Pharmacy, Lexington, KY, USA.
FAU - Beavers, Craig
AU  - Beavers C
AD  - University of Kentucky HealthCare, Lexington, KY, USA.
AD  - University of Kentucky School of Pharmacy, Lexington, KY, USA.
FAU - Xiaoshu, Li
AU  - Xiaoshu L
AD  - Center for Health Service Research, University of Kentucky College of Medicine, 
      Lexington, KY, USA.
FAU - Ather, Ayesha
AU  - Ather A
AD  - University of Kentucky HealthCare, Lexington, KY, USA.
AD  - University of Kentucky School of Pharmacy, Lexington, KY, USA.
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*administration & dosage/adverse effects
MH  - Coronary Artery Bypass/*methods
MH  - Enoxaparin/*administration & dosage/adverse effects
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin/*administration & dosage/adverse effects
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Patient Readmission/statistics & numerical data
MH  - Postoperative Care/methods
MH  - Respiration, Artificial/statistics & numerical data
MH  - Retrospective Studies
MH  - Venous Thromboembolism/*prevention & control
EDAT- 2019/06/17 06:00
MHDA- 2020/04/21 06:00
CRDT- 2019/06/17 06:00
PHST- 2019/06/17 06:00 [pubmed]
PHST- 2020/04/21 06:00 [medline]
PHST- 2019/06/17 06:00 [entrez]
AID - 10.1007/s40256-019-00354-4 [pii]
AID - 10.1007/s40256-019-00354-4 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2019 Dec;19(6):589-595. doi: 10.1007/s40256-019-00354-4.