Why the study?
Does high-dose certoparin (5,000 IU aXa/day) reduce the incidence of deep vein thrombosis compared to standard-dose certoparin (3,000 IU aXa/day) in patients undergoing elective hip replacement surgery?
Does high-dose certoparin (5,000 IU aXa/day) reduce the incidence of deep vein thrombosis compared to standard-dose certoparin (3,000 IU aXa/day) in patients undergoing elective hip replacement surgery?
Increasing the dose of certoparin from 3,000 IU to 5,000 IU daily does not improve DVT prevention after elective hip replacement but increases the risk of heparin-related bleeding.
Higher-dose certoparin fails to reduce DVT after hip replacement; confirms standard dosing suffices and cautions against escalation to limit bleeding.
BACKGROUND: The aim was to investigate, whether 5,000 IUaXa/day certoparin lowers the incidence of deep vein thrombosis (DVT) in patients undergoing elective hip replacement surgery vs. 3,000 IUaXa/day. Double-blind, multicenter, randomised trial in 500 patients. Primary endpoint: incidence of symptomatic or asymptomatic DVT (bilateral ascending venography). RESULTS: Mean age was 71 ± 10 years with a higher prevalence of previous DVT (8vs.4%) and pulmonary embolism (PE) (4vs.1%) in the high dose group. Mean duration of surgery was 82 ± 32 and 85 ± 36 min. DVT was detected in 28 (11.1%) of the low dose and 35 (14.1%) of the high dose group (p = n.s.). Combined distal-proximal DVT was observed in 5 (2%) and 4 (1.6%) patients respectively. No difference in bleeding events was found. CONCLUSION: This trial confirms prior data showing that the conventional dosage of 3,000 IU aXa is effective and safe for the prevention of venous thromboembolic events after hip replacement surgery.
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Bramlage et al. (2012) studied this question.
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