| Prospective comparison of three enoxaparin dosing regimens to achieve target anti-factor Xa levels in hospitalized, medically ill patients with extreme obesity. | |
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MedLine Citation:
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PMID: 22565589 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Enoxaparin is commonly used to prevent venous thromboembolism(VTE) [1,2] but has not been well-studied in patients with extreme obesity,a population at high risk for VTE. We prospectively compared three enoxaparin dosing regimens for the achievement of goal peak anti-Factor Xa levels in medically ill patients (n 5 31) with extreme obesity (body mass index (BMI) ‡ 40 kg/m2). Patients were assigned to receive fixed-dose (FD) enoxaparin 40 mg daily (QDay, n 5 11), weight based,lower-dose (LD) enoxaparin 0.4 mg/kg QDay (n 5 9), or weight based,higher-dose (HD) enoxaparin 0.5 mg/kg QDay (n 5 11). The average BMI and weight of the entire cohort was 62.1 kg/m2 (range40.5–82.4) and 176 kg (range 115–256 kg) and did not differ between groups. Peak anti-Factor Xa levels were significantly higher in the HD group compared to either LD or FD groups. Patients in the HD group achieved target anti-Factor Xa levels more frequently than the LD and FD groups (P < 0.05). Peak anti-Factor Xa levels did not correlate with age, weight, BMI, or creatinine clearance, demonstrating the predictability of weight-based enoxaparin dosing. There were no adverse events (e.g., bleeding, thrombosis, thrombocytopenia). To our knowledge this is the first prospective comparative study demonstrating that in extremely obese, medically ill patients enoxaparin 0.5 mg/kg QDay is superior to FD and LD enoxaparin for the achievement of target anti-Factor Xa levels. |
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Authors:
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Andrew Freeman; Tuesdy Horner; Robert C Pendleton; Matthew T Rondina |
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Publication Detail:
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Type: Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, N.I.H., Extramural Date: 2012-05-06 |
Journal Detail:
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Title: American journal of hematology Volume: 87 ISSN: 1096-8652 ISO Abbreviation: Am. J. Hematol. Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-06-14 Completed Date: 2012-08-27 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 7610369 Medline TA: Am J Hematol Country: United States |
Other Details:
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Languages: eng Pagination: 740-3 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anticoagulants / administration & dosage*, adverse effects, therapeutic use Bed Rest / adverse effects* Blood Coagulation Tests Body Mass Index Cohort Studies Dose-Response Relationship, Drug Enoxaparin / administration & dosage*, adverse effects, therapeutic use Factor Xa / antagonists & inhibitors* Female Humans Male Middle Aged Obesity, Morbid / blood*, complications, physiopathology, therapy Pilot Projects Venous Thromboembolism / etiology, prevention & control* |
| Grant Support | |
ID/Acronym/Agency:
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K23 HL092161/HL/NHLBI NIH HHS; K23HL092161/HL/NHLBI NIH HHS; R03 AG040631/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Enoxaparin; EC 3.4.21.6/Factor Xa |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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