Abstract
BACKGROUND: Venous thromboembolism is an important patient safety issue in thoracic surgery patients. The optimal enoxaparin dose remains unclear. This multicenter pre/post clinical trial compared the pharmacokinetics of fixed versus weight-tiered enoxaparin, and their impact on 90-day venous thromboembolism and bleeding.
METHODS: Thoracic surgery patients were prospectively enrolled using a pre/post study design Cohort 1 received enoxaparin 40mg daily, and Cohort 2 received a weight-tiered regimen (<70kg
RESULTS: One hundred thirty one patients were prospectively enrolled, including 65 in the fixed dose and 66 in the weight-tiered cohort. No patient was lost to followup. Weight-tiered enoxaparin was not significantly more likely to produce adequate anticoagulation (peak anti-Factor Xa ≥0.3 IU/mL) when compared to fixed dose enoxaparin (44.3% vs. 48.2%, p=0.67). Weight-tiered enoxaparin was not more likely to avoid over-anticoagulation (peak aFXa ≥0.5 IU/mL) when compared to fixed dose enoxaparin (3.3% vs. 3.6%, p=1.00). The groups had no significant difference in trough anti-Factor Xa. Observed rates of 90-day symptomatic VTE and clinically relevant bleeding were low (0% and 3.1%, respectively) and were not significantly different between groups.
CONCLUSIONS: This multicenter pre/post clinical trial did not show a pharmacokinetic advantage to weight-tiered enoxaparin, when compared fixed dose enoxaparin, in thoracic surgery patients.
PMID: 32045583 [PubMed - as supplied by publisher]
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pubmed: caandvteortroorpul
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