Bleeding During Enoxaparin Treatment More Common with Age Over 75 Years and Severe Renal Insufficiency
- PDF / 112,242 Bytes
- 3 Pages / 504 x 720 pts Page_size
- 71 Downloads / 141 Views
SHORT COMMUNICATION
© 2007 Adis Data Information BV. All rights reserved.
Bleeding During Enoxaparin Treatment More Common with Age Over 75 Years and Severe Renal Insufficiency Nebojsa Despotovic,1 Predrag Erceg,1 Maja Nikolic-Despotovic,2 Dragoslav P. Milosevic1 and Mladen Davidovic1 1 2
Gerontology Department, City Hospital Zvezdara, Belgrade, Serbia Cardiology Department, City Hospital Zvezdara, Belgrade, Serbia
Abstract
Background: Severe renal insufficiency, defined as a creatinine clearance 75 years were determined by investigating the parameters of efficacy (ischaemic event, lethal outcome), safety (bleeding events, renal insufficiency) or both (composite endpoint: ischaemic event or lethal outcome or bleeding event). Results: The study included 113 patients (59 male, 52.2%) with AMI aged >75 years; 36 of these patients received enoxaparin. In the patients who had severe renal insufficiency, bleeding events were more frequent in those receiving enoxaparin than in those patients who received UFH (3 vs 1, respectively; p = 0.024). Irrespective of the presence of renal insufficiency, bleeding events occurred more often in patients who received enoxaparin than in those who received UFH (13 vs 8, respectively; p = 0.007). The composite endpoint showed a nonsignificantly better profile in patients who received enoxaparin than in those who received UFH. Conclusion: Although the use of enoxaparin (compared with UFH) and the presence of severe renal insufficiency significantly increased the occurrence of bleeding in patients with AMI aged >75 years, the risk/benefit difference in this population was not significant.
Background By increasing the anti-Xa level, severe renal insufficiency, defined as a creatinine clearance (CLCR) of 75 years by investigating parameters of efficacy (ischaemic event, lethal outcome), safety (bleeding events, renal insufficiency) or both (composite endpoint: ischaemic event, lethal outcome or bleeding event). Patients and Methods Each successively hospitalised patient with AMI received enoxaparin (1 mg/kg/12 hours) or UFH
(1000 IU/hour) for at least 5 days. Whether the patient received enoxaparin or UFH was decided by his or her own physician (pseudo-randomisation; retrospective study). Bleeding events were registered using Thrombolysis In Myocardial Infarction (TIMI) grade bleeding criteria (major bleeding, minor bleeding, ‘loss no site’ [minor bleeding, but without a known site of bleeding] and other forms of bleeding).[5] Ischaemic events included recurrent angina, myocardial re-infarction and need for urgent myocardial revascularisation. Severe renal insufficiency was defined as a minimum measured CLCR of 75 years. Another 169 patients with AMI were aged 66–75 years, while 183 patients were ≤65 years. Of 36 patients who received enoxaparin (five of whom had severe renal insufficiency), bleeding events were registered more often in patients with severe renal insufficiency than in those without severe renal insufficiency (3 vs 10, respectively; p = 0.040 by χ2 test). This could be
Data Loading...
