Low molecular weight heparin once daily compared with conventional low-dose heparin twice daily. A prospective double-blind multicentre trial on prevention of postoperative thrombosis

Abstract

In a randomized, prospective, double-blind multicentre trial, the effect of conventional low-dose heparin 5000 units twice daily, was compared with that of a low molecular weight heparin fragment (4000-5000) 5000 anti-factor Xa units once daily. Four hundred and thirty-two patients fulfilled the inclusion criteria and were analysed for development of deep vein thrombosis (125I-labelled fibrinogen test) and haemorrhagic complications. Thrombosis occurred in a 4.3 per cent of patients in the low-dose heparin group and in 6.4 per cent of patients in the heparin fragment group, a difference which is not significant. There was a significant delay in the onset of thrombosis in the heparin fragment group. Mortality did not differ between the groups, nor did peroperative blood loss or transfusion requirements or infectious complications. Haemorrhagic complications occurred significantly more often in the fragment group (11.6 per cent) than in the conventional heparin group (4.6 per cent). Patients in the heparin fragment group experienced local pain following the subcutaneous injection significantly less often.

Efficacy and Safety of Weight-Adapted Nadroparin Calcium vs. Heparin Sodium in Prevention of Clinically Evident Thromboembolic Complications in 1,190 General Surgical Patients

“…The incidence of DVT (clinically evident) observed in our population is substantially lower than that reported in the literature using various LMWHs [18, 19, 20, 21]. Besides the specifically used LMWHs, this can be attributed to several different factors.…”

Low molecular weight heparin for the prevention of venous thromboembolism after abdominal surgery

“…Two original studies in 1986 reported that prophylaxis with LMWH in elective major abdominal surgery is as effective as UFH in preventing postoperative thrombosis 10,11 . Bergqvist et al 10 reported a double-blind *No statistical evaluation published in original paper; **all patients also received dihydroergotamine; †all patients wore elastic compression stockings; ‡trend only as study was stopped prematurely.…”

Randomized Trial of a Low-Molecular-Weight Heparin (Kabi 2165) versus Adjusted-Dose Subcutaneous Standard Heparin in the Prophylaxis of Deep-Vein Thrombosis after Elective Hip Surgery

“…Recently, several wellconducted, randomized, clinical trials have clearly established that LMWHs adminis tered once daily are as effective as standard heparin given twice daily in preventing post operative thrombosis in general surgery [14][15][16][17]. However, increased bleeding was ob served in two trials [14,16] and correlated with a high plasma anti-Xa activity. The question arises whether LMWHs given at a fixed-dose are effective and safe in prevent ing postoperative DVT in elective hip sur gery.…”