Prescribing patterns and outcomes of enoxaparin for anticoagulation of atrial fibrillation.
OBJECTIVE
To determine prescribing patterns and clinical outcomes of enoxaparin for anticoagulation of atrial fibrillation.


METHODS
Retrospective analysis.


METHODS
A 650-bed, tertiary care, community teaching hospital.


METHODS
Two hundred thirteen patients who received enoxaparin for thromboprophylaxis during an episode of atrial fibrillation. Intervention. Data collection on demographics, antithrombotic usage, and thrombotic and bleeding episodes from January-June 2001.


RESULTS
Patients were characterized as having acute (51.6%) or chronic (48.4%) atrial fibrillation and were categorized according to stroke risk. Three enoxaparin dosing strategies had been prescribed: therapeutic, prophylactic, or adjusted. Prescribed regimens did not reflect stroke risk or type of atrial fibrillation but did reflect the degree of renal impairment. No episodes of stroke occurred with therapeutic enoxaparin dosages, but five strokes occurred among patients receiving prophylactic or adjusted dosages. Bleeding was similar with all dosing strategies in patients with adequate renal function and appeared to be more frequent in those with renal impairment.


CONCLUSIONS
At a single hospital, wide variation in enoxaparin prescribing patterns existed. Further study is necessary to elucidate more fully the appropriate dosing strategy for this agent in the treatment of atrial fibrillation.
Department of Pharmacy, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.
Minou
M
Khazan
Sonya
S
Scheuering
Robert
R
Adamson
A Scott
AS
Mathis
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D003625:Data Collection; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D017984:Enoxaparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced / Q000453:epidemiology; D016896:Treatment Outcome
D000925:Anticoagulants; D017984:Enoxaparin