What does this research mean for the field?

Low-molecular-weight heparin (LMWH) is a safe and effective long-term alternative anticoagulant for outpatients who experience bleeding complications or severe side effects from oral anticoagulants. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 1, 1997Seminars in Thrombosis and Hemostasis

Long-Term Anticoagulation of Outpatients with Adverse Events to Oral Anticoagulants Using Low-Molecular-Weight Heparin

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Why the study?

Does low-molecular-weight heparin safely and effectively provide long-term anticoagulation in outpatients who have experienced adverse events on oral vitamin K antagonists?

Population

120 outpatients requiring further anticoagulation who were switched from oral anticoagulants due to bleeding…

Design

Cohort, nonrandomized

Follow-up

2 months to 10.8 years

Authors

JHJob HarenbergHeidelberg University GHGünter HuhleIndustrial Union of Metalworkers LPLukas Piazolo

Discussion

Member takes

Implication

May support LMWH as long-term option after VKA intolerance; hypothesis-generating and requires randomized confirmation before practice change.

Structured PICO

Does low-molecular-weight heparin safely and effectively provide long-term anticoagulation in outpatients who have experienced adverse events on oral vitamin K antagonists?

Population

120 outpatients requiring further anticoagulation (for prophylaxis of recurrent thromboembolism, artificial heart valve replacement, atrial fibrillation with embolism, or cardiomyopathy) who were switched from oral anticoagulants (vitamin K antagonists) due to bleeding complications or other severe side effects.

Intervention

Low-molecular-weight heparin (LMWH) injected subcutaneously at doses ranging from 2500 to 15,000 anti-factor Xa units per day (self-administered, adjusted based on body weight, bleeding risk, and thromboembolic risk) for a period ranging from 2 months to 10.8 years.

Outcome

Incidence of fatal embolism, bleeding episodes, and side effects (including drop in platelet count)safety

Long-term subcutaneous low-molecular-weight heparin appears to be a safe and effective alternative for patients requiring anticoagulation who cannot tolerate vitamin K antagonists due to bleeding or other severe side effects.

Cite This Study

Harenberg et al. (1997) studied this question.

synapsesocial.com/papers/6a15867f79ff98d0de4ec28e https://doi.org/10.1055/s-2007-996086

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF Cardiomyopathy

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Implication

May support LMWH as long-term option after VKA intolerance; hypothesis-generating and requires randomized confirmation before practice change.

Long-Term Anticoagulation of Outpatients with Adverse Events to Oral Anticoagulants Using Low-Molecular-Weight Heparin

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Topics

Long-Term Anticoagulation of Outpatients with Adverse Events to Oral Anticoagulants Using Low-Molecular-Weight Heparin

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider