title: Safety of dalteparin for the prophylaxis of venous thromboembolism in elderly medical patients with renal insufficiency: a pilot study.
abstract: The aim of this prospective cohort study was to determine the incidence of dalteparin bioaccumulation (measured using anti-Xa levels), and bleeding during thromboprophylaxis in elderly patients with renal failure who were admitted to hospital with an acute medical illness. Patients who met the criteria for being at high thromboembolic risk received dalteparin 5,000 IU subcutaneously once daily while the other patients (low risk) received 2,500 IU daily. Thromboprophylaxis was administered for at least 6 days. Anti-Xa activity was determined before the first dalteparin dose and again on day 6, 4 hours after the administration of the dalteparin dose. Bleeding was assessed daily. Compression ultrasonography was performed to identify any deep vein thromboses. There was no evidence of bioaccumulation on day 6 of therapy, irrespective of renal function. No episodes of major bleeding or venous thromboembolism occurred. Larger, randomized studies are warranted to confirm the safety of dalteparin in this patient population.
authors.affiliation: Unità Operativa Medicina Interna Cardiovascolare, Nuovo Ospedale Civile di Modena S. Agostino-Estense, Baggiovara, Italy. e.tincani@ausl.mo.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Tincani
authors.forename: Caterina
authors.initials: C
authors.lastname: Mannucci
authors.forename: Barbara
authors.initials: B
authors.lastname: Casolari
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Turrini
authors.forename: Mark A
authors.initials: MA
authors.lastname: Crowther
authors.forename: Domenico
authors.initials: D
authors.lastname: Prisco
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Cenci
authors.forename: Marco
authors.initials: M
authors.lastname: Bondi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017985:Dalteparin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000633:toxicity; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011292:Premedication; D051437:Renal Insufficiency / Q000150:complications* / Q000188:drug therapy; D013923:Thromboembolism / Q000150:complications / Q000188:drug therapy; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D006495:Heparin, Low-Molecular-Weight; D017985:Dalteparin