Enoxaparin Bests Unfractionated Heparin in Occlusive PAD

Enoxaparin performs better than unfractionated heparin in peripheral arterial occlusive disease

MONDAY, Sept. 19 (HealthDay News) -- Intravenous enoxaparin is safe and more effective than unfractionated heparin (UFH) for treating peripheral arterial occlusive disease (PAOD), according to a study published online Sept. 12 in the Journal of Thrombosis and Haemostasis.

Nikolaus Duschek, M.D., from the Wilhelminenspital in Vienna, Austria, and colleagues investigated whether intravenous enoxaparin is an effective and safe alternative to UFH for treating PAOD. A total of 210 patients with PAOD were randomly allocated to receive an intravenous bolus of 60 units UFH/kg body weight or 0.5 mg enoxaparin/kg body weight in a 1:2 ratio, respectively, before endovascular intervention. The primary composite end point evaluated the clinical performance of enoxaparin by comparing the peri-interventional rate of thrombembolia/occlusion (efficacy) of endovascularly reconstructed areas, bleeding (safety), and required reintervention for any plasma thromoboplastin antecedent-related bleeding. Anti-FactorXa (anti-Xa) levels during intervention were assessed as the secondary end point.

The investigators found that enoxaparin performed significantly better in the primary composite end point. The risk of complications significantly increased with the concomitant use of acetyl salicylic acid in the UFH group, but not in the enoxaparin group. Anti-Xa levels were reached within 15 minutes by 63.7 percent of the patients treated with enoxaparin and 39.1 percent treated with UFH.

"Enoxaparin has a better performance than UFH in endovascular interventions for the treatment of PAOD," the authors write.

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