LMWH for perioperative anticoagulation in patients on chronic warfarin therapy.
OBJECTIVE
To review current data regarding low-molecular-weight heparin (LMWH) use for perioperative anticoagulation in patients receiving chronic warfarin therapy.


METHODS
Data were obtained from the Sixth American College of Chest Physicians Consensus Conference on Antithrombotic Therapy guidelines and a MEDLINE search (1996-January 2003). Search terms included heparin, low-molecular-weight heparin, warfarin, perioperative care, and anticoagulants.


RESULTS
Heparin is the most common agent used as bridge therapy for perioperative anticoagulation in patients on chronic warfarin therapy; LMWHs are also used. Studies that evaluated enoxaparin and/or dalteparin were reviewed.


CONCLUSIONS
Although published studies demonstrate efficacy and safety of LMWHs, more data are needed to support their use as bridge therapy.
Heuts
Luke M
LM
Nash General Hospital, 2460 Curtis Ellis Drive, Rocky Mount, NC 27804-2237, USA. lmheuts@nhcs.org
Arvik
Beth M McLendon
BM
Cender
Dawn E
DE
D000925:Anticoagulants / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D019990:Perioperative Care; D013923:Thromboembolism / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin