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Once versus twice daily enoxaparin for the initial treatment of acute venous thromboembolism

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Trujillo-Santos, J
  • Bergmann, JF
  • Bortoluzzi, C
  • Giorgi-Pierfranceschi, M
  • Lopez-Saez, JB
  • Ferrazzi, P
  • Bascuñana J
  • Suriñach JM
  • Monreal, M

Grupos

Abstract

Background In patients with acute venous thromboembolism (VTE), it is uncertain whether enoxaparin should be administered twice or once daily. Methods We used the RIETE Registry data to compare the 15- and 30-day rates of VTE recurrence, major bleeding and death between patients receiving enoxaparin twice daily and those receiving it once daily. We used propensity score matching to adjust for confounding variables. Results The study included 4730 patients: 3786 (80%) received enoxaparin twice daily and 944 once daily. During the first 15days, patients on enoxaparin once daily had a trend towards more VTE recurrences (odds ratio [OR], 1.79; 95% confidence interval [CI], 0.55-5.88), fewer major bleeds (OR, 0.42; 95% CI, 0.17-1.08) and fewer deaths (OR, 0.32; 95% CI, 0.13-0.78) than those on enoxaparin twice daily. At day 30, patients on enoxaparin once daily had more VTE recurrences (OR, 2.5; 95% CI, 1.03-5.88), fewer major bleeds (OR, 0.40; 95% CI, 0.17-0.94) and fewer deaths (OR, 0.58; 95% CI, 0.33-1.00). On propensity analysis, patients on enoxaparin once daily had fewer major bleeds at 15 (hazard ratio [HR], 0.30; 95% CI, 0.10-0.88) and at 30days (HR, 0.16; 95% CI, 0.04-0.68) and also fewer deaths at 15 (HR, 0.37; 95% CI, 0.14-0.99) and at 30days (HR, 0.19; 95% CI, 0.07-0.54) than those on enoxaparin twice daily. Conclusions Our findings confirm that enoxaparin prescribed once daily results in fewer major bleeds than enoxaparin twice daily, as suggested in a meta-analysis of controlled clinical trials.

Datos de la publicación

ISSN/ISSNe:
1538-7933, 1538-7836

JOURNAL OF THROMBOSIS AND HAEMOSTASIS  WILEY-BLACKWELL

Tipo:
Article
Páginas:
429-438
Factor de Impacto:
2,353 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 10

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Keywords

  • bleeding; enoxaparin; mortality; recurrences; regimen; venous thromboembolism

Proyectos asociados

ESTUDIO RETROSPECTIVO, POSAUTORIZACIÓN DE TIPO OBSERVACIONAL (EPA-OD), MULTICÉNTRICO, EN PACIENTES CON HAP TRATADOS CON OPSUMIT® (MACITENTAN) SEGÚN PRÁCTICA CLÍNICA HABITUAL EN ESPAÑA. PRACMA.

Investigador Principal: LUIS ALMENAR BONET

ACT-MAC-2015-01 . 2015

REGISTRO GLOBAL ANTICOAGULANTE SOBRE EL TERRENO (GLOBAL ANTICOAGULANT REGISTRY IN THE FIELD) DE OBSERVACIÓN DEL TRATAMIENTO Y LOS RESULTADOS EN PACIENTES CON EPISODIOS TROMBOEMBÓLICOS VENOSOS EN CASOS REALES.

Investigador Principal: RAQUEL LÓPEZ REYES

THR-AVK-2015-01 . 2016

EXPERT, EXPOSURE REGISTRY RIOCIGUAT (REGISTRO DE EXPOSICIÓN A RIOCIGUAT) EN PACIENTES CON HIPERTENSIÓN PULMONAR.

Investigador Principal: RAQUEL LÓPEZ REYES

BAY-RIO-2015-01 . 2016

EVOLUCION DEL TRATAMIENTO Y USO DE RECURSOS SANITARIOS DE LA HIPERTENSION ARTERIAL PULMONAR Y LA HIPERTENSION PULMONAR TROMBOEMBOLICA CRONICA-ESTUDIO EUROPEO.

Investigador Principal: DOLORES NAUFFAL MANZUR

BAY-HTP-2009-01 . 2010

ESTUDIO LONGITUDINAL PARA IDENTIFICAR CRITERIOS PREDICTIVOS DE HIPERTENSIÓN PULMONAR POSTROMBÓTICA.

Investigador Principal: RAQUEL LÓPEZ REYES

OSIRIS

ESTUDIO DE FASE 2, ALEATORIZADO, DOBLE CIEGO, CONTROLADO CON PLACEBO, DE BÚSQUEDA DE DOSIS DE GS-4997 EN PACIENTES CON HIPERTENSIÓN ARTERIAL PULMONAR.

Investigador Principal: RAQUEL LÓPEZ REYES

GS-US-357-1394

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