Key result
Antithrombotic prophylaxis cuts VTE risk ~49% in acutely ill medical patients but increases bleeding.
Why the study?
Despite guidelines recommending prophylactic antithrombotic measures, there is a low tendency to use these drugs in acutely ill hospitalized medical patients to prevent VTE.
Does prophylaxis with antithrombotic drugs (low-molecular-weight heparin and fondaparinux) reduce venous thromboembolism in acutely ill hospitalized medical patients?
Meta-Analysis (n=16,524)
Does prophylaxis with antithrombotic drugs (low-molecular-weight heparin and fondaparinux) reduce venous thromboembolism in acutely ill hospitalized medical patients?
In acutely ill medical patients, LMWH and fondaparinux prophylaxis reduces VTE and DVT risk but increases the risk of hemorrhage without affecting mortality.
Supports antithrombotic prophylaxis in acutely ill medical patients with bleeding-risk assessment; confirms VTE reduction in Level 1 meta-analysis.
Venous thromboembolism (VTE) represents a severe complication for acutely ill hospitalized medical patients. Despite several guidelines suggesting that prophylactic measures significantly reduce the risk of VTE, there is a scarce tendency to use antithrombotic drugs in these patients. We performed a meta-analysis of the interventional trials with antithrombotic drugs (low-molecular-weight heparin and fondaparinux) to oversee the clinical effectiveness and bleeding complications. A total of eight randomized controlled trials, including 16,524 patients, were analyzed. This meta-analysis suggests that in acutely ill medical patients, compared with controls, prophylaxis with antithrombotic drugs may be of clinical benefit in VTE (odds ratio [OR]: 0.512; 95% CI: 0.41–0.64; p < 0.001) and deep venous thrombosis (OR: 0.520; 95% CI: 0.41–0.67; p < 0.001); furthermore, there is no effect on pulmonary embolism, VTE‐related death and death from any other cause, and significant enhancement of hemorrhages (OR: 1.465; 95% CI: 1.2–1.79; p < 0.001). Future clinical trials should better define the risk factors for VTE in order to provide the optimal care for acutely ill medical patients.
No takes yet. Share an insight, caveat, or question.
Loffredo et al. (2013) conducted a meta-analysis in Acutely ill hospitalized medical patients (n=16,524). Antithrombotic drugs (low-molecular-weight heparin and fondaparinux) vs. Controls was evaluated on Venous thromboembolism (VTE) (OR 0.512, 95% CI 0.41-0.64, p=< 0.001). Prophylaxis with antithrombotic drugs in acutely ill medical patients significantly reduced the risk of VTE (OR 0.512; 95% CI 0.41-0.64; p<0.001) but increased hemorrhages.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: