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Showing 3 results for Enoxaparin
Low molecular weight heparin versus Unfractionated heparin in patients with non ST-elevation acute coronary syndrome: a randomaized clinical trial
Zandparsa A F, Jafari H, Tabatabai Gh,
Volume 65, Issue 6 (9-2007)
Abstract

Background: Despite the overwhelming progress that has been accomplished in the prevention of mortality due to cardiovascular disease, coronary artery disease (CAD) is the leading cause of death in the world.

The aim of this study was to compare of the effects of enoxaparin versus unfractionated heparin (UFH) on major clinical events, including mortality, myocardial infarction (MI), and recurrent angina, as well as bleeding in patients with non ST elevation acute coronary syndrome (NSTEACS). We also studied the need for coronary angiography and revascularization (PCI or CABG) in these patients.

Method: Two-hundred patients were enrolled in this study, 100 of whom received intravenous UFH (an initial bolus of 5000 U followed by continuous infusion of 1000 U/h) and 100 received enoxaparin subcutaneous injections of 1mg/kg twice daily for a minimum of 72 h. During their admission we recorded data regarding death, MI, recurrent angina, need for angiography and revascularization, and major and minor bleeding.

Results: The incidence of recurrent angina, total mortality and the need for revascularization were significantly lower in patients receiving enoxaparin compared to those receiving UFH, at 17% vs. 39% (p=0.002), 0% vs. 3% (p=0.035), 14% vs. 33% (p=0.001), respectively. However, there was no significant difference regarding the incidence of MI, major bleeding and cardiac death between the two groups.

Conclusions: This study showed that, in patients with NSTEACS, enoxaparin was superior to UFH regarding the prevention of major in-hospital clinical events, especially recurrent angina and the need for revascularization. We therefore recommend enoxaparin as an alternative antithrombotic agent to UFH in patients with NSTEACS.


Rivaroxaban versus enoxaparin for treatment of patients with nonhematologic cancer with venous thromboembolism a randomized clinial trial
Seyed Hamid Borsi, Hanieh Raji, Mehrdad Dargahi Malamir , Forogh Nokhostin, Afrooz Kargaran,
Volume 79, Issue 4 (7-2021)
Abstract
Background: Low-Molecular-Weight Heparin (LMWH) is recommended as the first-line treatment in patients with active cancer and venous thromboembolism (VTE), but many patients prefer to take oral anticoagulants and non-injectable forms with more reasonable price. Venous thromboembolism is a very common comorbidity in patients with cancer. Therefore, the aim of this study was to evaluate the efficacy and safety of the rivaroxaban compared with enoxaparin in patients with cancer and VTE.
Methods: This randomized clinical trial was conducted on 50 patients with non-hematologic cancer and deep vein thrombosis (DVP) or pulmonary thromboembolism (PTE) enrolled into Imam Khomeini hospital, from November 2019 to March 2020 in Ahvaz. The participants randomly assigned in two treatment groups (25 patients in each group) of rivaroxaban (15 mg every 12 hours for the first three weeks and then orally at 20 mg daily) or enoxaparin (1 mg/kg by subcutaneous injection every 12 hours) and followed for 6 months to evaluate the efficacy, complications and safety (incidence of recurrent VTE, major bleeding and deaths) of these therapies in Ahvaz.
Results: The three most common cancer diagnoses were breast (n=11, 22%), colon (n=10, 20%), and lung (n=7, 14%). Major bleeding at 6 months was only seen in one patient (4%) in the enoxaparin group and did not occur in the rivaroxaban group (P>0.05). Minor bleeding occurred in 1 patient (4%) in the rivaroxaban group and did not occur in the enoxaparin group (P>0.05). One patient in the enoxaparin group died because of fever and neutropenia. The prevalence of DVT and PTE in cancer patients was not significantly different based on patient age (P=0.154), gender (P=0.430), BMI (P=0.490), underlying disease (P=0.294), smoking (P=0.955), type of cancer (P=0.527), and metastatic cancer (P=0.280).
Conclusion: The results of this study suggest that the efficacy of rivaroxaban is not less than that of enoxaparin and therefore can be a potential option for patients with non-hematologic cancer and VTE. However, further randomized, controlled trials are needed to confirm these results.
 

The effects of preoperative prophylactic administration of enoxaparin on intraoperative and postoperative bleeding in hip fracture surgeries
Mohammad Golparvar, Fatemeh Moghadassi ,
Volume 82, Issue 7 (10-2024)
Abstract
Background: Intraoperative bleeding is an unwanted and common complication in orthopedic surgeries, which can be aggravated by the preventive administration of anticoagulants to prevent deep vein thrombosis. The present study examines the effect of prophylactic enoxaparin to prevent thromboembolism on the amount of bleeding in femoral head surgeries where it is not possible to use a tourniquet.
Methods: A prospective descriptive-analytical study was conducted from July to March 2017 in Kashani Hospital, Isfahan, in 120 patients without a history of coagulation disorders who were candidates for reconstructive surgery for femoral head and neck fractures. Inclusion criteria involved age over 18, BMI less than 30, no history of coagulation disorders, no preoperative use of anticoagulant drugs, normal PT, PTT, and INR before starting enoxaparin. The patients didn’t have any coagulation disorder and all of them were under prophylactic dose of enoxaparin before surgery. The patients were subjected to spinal anesthesia with the same method. Signs related to degree of bleeding recorded during surgery and recovery care.  Data were collected and entered into SPSS software version 20, and central tendency and dispersion indices were calculated for quantitative variables. Descriptive tables and charts were utilized for qualitative variables. Correlation coefficient and linear regression analyses were performed for the final interpretation of results.
Results: There was a significant relationship between mean arterial pressure and intraoperative bleeding (p-value=0.001). The dose of enoxaparin prescribed was associated with the volume of fluids received, the amount of bleeding, the amount of tranexamic acid, phenylephrine, labetalol, TNG and fentanyl administered during the operation with a p-value of less than 0.05. Also, there is a significant relationship between the prescribed dose of enoxaparin and the duration of surgery and duration of recovery care (p-value less than 0.05).
Conclusion: The study examines the impact of prophylactic enoxaparin on intraoperative bleeding, finding a significant correlation with dosage and duration. No notable difference in bleeding was observed in patients with a GFR below 30. Enoxaparin administration correlated with increased bleeding, MAP levels, fluid volume, tranexamic acid use, and hypotension medications during surgery.

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