Comparison of low-molecular-weight-heparin and unfractionated heparin for acute PTE.
OBJECTIVE
Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) is clinically as efficient and safe as unfractionated heparin (UH) in patients with diagnosis of acute non-massive PTE, our study compares the efficacy, adverse effects and costs of LMWH and UH.


METHODS
One hundred and fourteen patients with non-massive acute PTE were randomly divided into LMWH (nadroparin calcium) and UH groups. Oxygenation index, D-dimer, fibrinogen (FG), lung ventilation/perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA) were observed before anticoagulation and on day 14 after anticoagulation.


RESULTS
In both groups, the ABG (arterial blood gas) analysis showed PaO(2) and PaCO(2) were elevated, P(A-a)O(2) was decreased and oxygenation index (PaO(2)/FIO(2)) was elevated, D-dimer and fibrinogen were decreased, lung V/Q and CTPA showed embolized segments reduced (P<0.05). Hemorrhage and thrombocytopenia occurred in 3.5% of the LMWH group. Hemorrhage occurred in 5.3% and thrombocytopenia occurred in 7.0% of the UH group. The average cost in the LMWH group was RMB 1218.60 Yuan and RMB 1541.40 Yuan in the UH group.


CONCLUSIONS
LMWH and UH are equally effective for treatment of non-massive acute PTE, but LMWH may have a lower prevalence of complications and is less expensive.
Chen
Li-ying
LY
Department of Internal Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China. cly0906@163.com
Ying
Ke-jing
KJ
Hong
Wu-jun
WJ
Zhou
Pan
P
D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006493:Heparin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; C078918:ITF 300; D006493:Heparin