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Latest & greatest articles for heparin
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Intravitreal low molecular weight heparin and 5-Fluorouracil for the prevention of proliferative vitreoretinopathy following retinal reattachment surgery. BACKGROUND: Proliferative vitreoretinopathy (PVR) is a significant cause of failure in retinal reattachment surgery. Various pharmacological agents have shown potential benefit in reducing postoperative PVR risk. OBJECTIVES: This review aimed to compare the use of intravitreal low molecular weight heparin (LMWH) alone or with 5-Fluorouracil (...) ). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 24 May 2010. SELECTION CRITERIA: We only included randomised controlled trials (RCTs) that compared intravitreal LMWH alone or with 5-FU, versus placebo for the prevention of postoperative PVR in patients undergoing primary vitrectomy for rhegmatogenous retinal detachment repair. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data
Bivalirudin vs. unfractionated heparin during percutaneous coronary interventions in patients with stable and unstable angina pectoris: 1-year results of the ISAR-REACT 3 trial 20150324 2010 03 04 2011 03 15 2016 11 25 1522-9645 31 5 2010 Mar European heart journal Eur. Heart J. Bivalirudin vs. unfractionated heparin during percutaneous coronary interventions in patients with stable and unstable angina pectoris: 1-year results of the ISAR-REACT 3 trial. 582-7 10.1093/eurheartj/ehq008 In ISAR (...) -REACT 3, 30-day outcomes in 4570 biomarker negative patients undergoing percutaneous coronary intervention (PCI) > or =2 h after pre-treatment with 600 mg of clopidogrel revealed less bleeding with bivalirudin compared with unfractionated heparin, but no difference in 30-day net clinical benefit. The objective of the present analysis was to assess the impact of bivalirudin vs. heparin on 1-year outcomes in ISAR-REACT 3. The primary outcome for this analysis was the composite of death
Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin 20194309 2010 03 02 2010 04 15 2016 05 12 1535-1386 92 3 2010 Mar The Journal of bone and joint surgery. American volume J Bone Joint Surg Am Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin. 527-35 10.2106/JBJS.I.00047 Thromboembolic (...) disease is a common complication of total hip arthroplasty. The purpose of this study was to compare a new mobile compression device with low-molecular-weight heparin with regard to their safety and effectiveness for the prevention of venous thromboembolic disease. Patients who had a total hip arthroplasty were randomized to receive prophylaxis with a mobile compression device or low-molecular-weight heparin for ten days. Use of the compression device began intraoperatively, and the patients
WITHDRAWN: Heparin for the prevention of venous thromboembolism in general medical patients (excluding stroke and myocardial infarction). BACKGROUND: Venous thromboembolic disease has been extensively studied in surgical patients. The benefit of thromboprophylaxis is now generally accepted, but it is medical patients who make up the greater proportion of the hospital population. Medical patients differ from surgical patients with regard to their health and the pathogenesis of thromboembolism (...) and the impact that preventative measures can have. The extensive experience from thromboprophylaxis studies in surgical patients is therefore not necessarily applicable to non-surgical patients. OBJECTIVES: To determine the effectiveness and safety of heparin thromboprophylaxis in general medical patients. SEARCH STRATEGY: The Cochrane Peripheral Vascular Diseases Group searched their Specialised Register (last searched 24 April 2009) and the Cochrane Central Register of Controlled Trials in The Cochrane
Mechanical compression versus subcutaneous heparin therapy in postoperative and posttrauma patients: a systematic review and meta-analysis Mechanical compression versus subcutaneous heparin therapy in postoperative and posttrauma patients: a systematic review and meta-analysis Mechanical compression versus subcutaneous heparin therapy in postoperative and posttrauma patients: a systematic review and meta-analysis Eppsteiner RW, Shin JJ, Johnson J, van Dam RM CRD summary This review found (...) that the risk of thromboembolic disease was similar for mechanical compression and heparin, but heparin was associated with a greater risk of bleeding in postsurgical/post-trauma patients. These conclusions are supported by the data, but should be interpreted with some caution due to the possibility of publication bias and lack of details on some aspects of trial quality. Authors' objectives To determine the impact of mechanical compression compared with subcutaneous heparin on venous thromboembolic disease
Safety and efficacy of prolonged use of unfractionated heparin after percutaneous coronary intervention Safety and efficacy of prolonged use of unfractionated heparin after percutaneous coronary intervention Safety and efficacy of prolonged use of unfractionated heparin after percutaneous coronary intervention Singh PP, Arora R, Singh M, Bedi US, Adigopula S, Singh S, Bhuriya R, Molnar J, Khosla S CRD summary This review concluded that routine use of unfractionated heparin after uncomplicated (...) percutaneous coronary intervention may have resulted in increased bleeding complications with no reduction in ischaemic complications. Further research was needed. Most of the data came from studies undertaken before use of stents/glycoprotein IIb/IIIa inhibitors was routine. The conclusions, which included the need for further research, appear reasonable. Authors' objectives To assess the safety and efficacy of prolonged infusion of unfractionated heparin after percutaneous coronary intervention (PCI
Low molecular weight heparin to achieve live birth following unexplained pregnancy loss: a systematic review. Low molecular weight heparin to achieve live birth following unexplained pregnancy loss: a systematic review. Low molecular weight heparin to achieve live birth following unexplained pregnancy loss: a systematic review. Mantha S, Bauer KA, Zwicker JI CRD summary This review concluded that although there was a trend for increased live births when low molecular weight heparin was used (...) for the prevention of recurrent pregnancy loss, there was insufficient evidence to support its routine use. Given the level of heterogeneity and consequent lack of statistical synthesis, the reliability of this conclusion is unclear. The recommendations for research were appropriate. Authors' objectives To assess the benefit of low molecular weight heparin (LMWH) in achieving live birth in women with a history of recurrent or late non-recurrent pregnancy loss who did not have antiphospholipid antibodies
Heparin for Acute Coronary Syndromes Heparin for Acute Coronary Syndromes – TheNNTTheNNT Heparin Given for Acute Coronary Syndromes (Unstable Angina, NSTEMI, STEMI) 25 for major bleeding In Summary, for those who took the heparin: Benefits in NNT None were helped (life saved) None were helped (preventing a nonfatal heart attack) 100% saw no benefit 0% were helped by being saved from death 0% were helped by preventing a nonfatal heart attack Harms in NNT 1 in 25 were harmed (major bleeding (...) tears in the innermost lining of the artery (the tears are caused by plaques poking through). The blood typically misinterprets these tears as bleeding and forms a clot where the tears are, clogging the artery. Heparin inhibits clotting which seems intuitively like it would help but by the time the patient has symptoms like chest pain a clot has already formed, so it's unclear how much this can help. In addition, anything that inhibits clotting can lead to bleeding. Eight randomized control trials
Long-term use of different doses of low-molecular-weight heparin versus vitamin K antagonists in the treatment of venous thromboembolism Long-term use of different doses of low-molecular-weight heparin versus vitamin K antagonists in the treatment of venous thromboembolism Long-term use of different doses of low-molecular-weight heparin versus vitamin K antagonists in the treatment of venous thromboembolism Romera-Villegas A, Cairols-Castellote MA, Vila-Coll R, Marti-Mestre X, Colome E, Iguaz I (...) CRD summary The authors concluded that full-dose low molecular weight heparin treatment for three to six months was as safe as intermediate and prophylactic doses for long-term treatment of deep vein thrombosis. Evidence was based on indirect comparisons, which combined with an inadequate study quality assessment and small numbers of events for some analyses means that the conclusions may not be reliable. Authors' objectives To evaluate the efficacy and safety of different doses
Neurological outcomes in patients with ischemic stroke receiving enoxaparin or heparin for venous thromboembolism prophylaxis: subanalysis of the Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study 19696423 2009 10 27 2009 11 23 2016 11 22 1524-4628 40 11 2009 Nov Stroke Stroke Neurological outcomes in patients with ischemic stroke receiving enoxaparin or heparin for venous thromboembolism prophylaxis: subanalysis of the Prevention of VTE after Acute Ischemic Stroke with (...) LMWH (PREVAIL) study. 3532-40 10.1161/STROKEAHA.109.555003 The Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study demonstrated that enoxaparin was superior to unfractionated heparin (UFH) in preventing venous thromboembolism in patients with ischemic stroke and was associated with a small but statistically significant increase in extracranial hemorrhage rates. In this PREVAIL subanalysis, we evaluate the long-term neurological outcomes associated with the use of enoxaparin
Low-dose vs standard-dose unfractionated heparin for percutaneous coronary intervention in acute coronary syndromes treated with fondaparinux: the FUTURA/OASIS-8 randomized trial. 20805623 2010 09 22 2010 09 24 2016 10 17 1538-3598 304 12 2010 Sep 22 JAMA JAMA Low-dose vs standard-dose unfractionated heparin for percutaneous coronary intervention in acute coronary syndromes treated with fondaparinux: the FUTURA/OASIS-8 randomized trial. 1339-49 10.1001/jama.2010.1320 The optimal unfractionated (...) heparin regimen for percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes treated with fondaparinux is uncertain. To compare the safety of 2 unfractionated heparin regimens during PCI in high-risk patients with non-ST-segment elevation acute coronary syndromes initially treated with fondaparinux. Double-blind randomized parallel-group trial in 179 hospitals in 18 countries involving 2026 patients undergoing PCI within 72 hours, nested within
Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. 20335572 2010 04 29 2010 05 04 2013 11 21 1533-4406 362 17 2010 Apr 29 The New England journal of medicine N. Engl. J. Med. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. 1586-96 10.1056/NEJMoa1000641 Aspirin and low-molecular-weight heparin are prescribed for women with unexplained recurrent miscarriage, with the goal of improving the rate of live births, but limited data from randomized
Comparison of bivalirudin monotherapy versus unfractionated heparin plus tirofiban in patients with diabetes mellitus undergoing elective percutaneous coronary intervention 19840566 2009 10 20 2009 11 24 2016 11 25 1879-1913 104 9 2009 Nov 01 The American journal of cardiology Am. J. Cardiol. Comparison of bivalirudin monotherapy versus unfractionated heparin plus tirofiban in patients with diabetes mellitus undergoing elective percutaneous coronary intervention. 1222-8 10.1016/j.amjcard (...) .2009.06.035 Bivalirudin demonstrated similar efficacy but resulted in a lower rate of bleeding compared to unfractionated heparin (UFH) plus platelet glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention. It has not been clearly evaluated whether this can also be applied to patients with diabetes mellitus. A total of 335 consecutive patients with diabetes mellitus referred for elective percutaneous coronary intervention were randomized in the Novel Approaches
Thrombolysis Compared With Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Sodium citrate versus heparin catheter locks for cuffed central venous catheters: a single-center randomized controlled trial 19394731 2009 05 25 2009 06 15 2013 04 04 1523-6838 53 6 2009 Jun American journal of kidney diseases : the official journal of the National Kidney Foundation Am. J. Kidney Dis. Sodium citrate versus heparin catheter locks for cuffed central venous catheters: a single-center randomized controlled trial. 1034-41 10.1053/j.ajkd.2009.01.259 Sodium citrate has antibacterial (...) and anticoagulant properties that are confined to the catheter when used as a catheter lock. Studies of its use as a catheter lock have suggested its efficacy in preventing infection and bleeding complications compared with sodium heparin. Open-label randomized controlled trial of 2 catheter locks to examine the hypothesis that sodium citrate catheter locks will reduce catheter-related bacteremia and exit-site infection. 232 consenting long-term hemodialysis patients in 4 satellite dialysis units to a large
Unfractionated Heparin Therapy in Infants and Children 19221154 2009 03 03 2009 03 30 2013 11 21 1098-4275 123 3 2009 Mar Pediatrics Pediatrics Unfractionated heparin therapy in infants and children. e510-8 10.1542/peds.2008-2052 Unfractionated heparin is frequently used in tertiary pediatric centers for the prophylaxis and treatment of thromboembolic disease. Recent evidence suggests that the clinical outcomes of unfractionated heparin therapy in children are poor, as determined by target (...) -range achievement and adverse-event rates. These reports of poor outcomes may be related to an age-dependent mechanism of action of unfractionated heparin. Furthermore, several published studies have indicated that unfractionated heparin-monitoring assays currently in clinical use have significant limitations that likely affect the safety and efficacy of anticoagulant management. This review summarizes the growing body of evidence suggesting that pediatric-specific recommendations for unfractionated
Unfractioned heparin for treatment of sepsis: A randomized clinical trial (The HETRASE Study) 19242322 2009 03 25 2009 05 05 2009 07 17 1530-0293 37 4 2009 Apr Critical care medicine Crit. Care Med. Unfractioned heparin for treatment of sepsis: A randomized clinical trial (The HETRASE Study). 1185-96 10.1097/CCM.0b013e31819c06bc The primary aims of this study were to determine the effects of heparin on length of stay and change from baseline multiple organ dysfunction (MOD) score. Secondary (...) objectives were to estimate the effects of heparin on 28-day all-cause mortality, and to determine the possible effect modification on 28-day all-cause mortality, in subgroups defined by site of infection and baseline values of Acute Physiology and Chronic Health Evaluation II score, MOD score, and d-dimer. Randomized, double-masked, placebo-controlled, single-center clinical trial, testing low dose continuous infusion of unfractioned heparin (UFH) as complementary treatment for sepsis. Five hundred
Heparin-Bonded Central Venous Catheters Do Not Reduce Thrombosis in Infants With Congenital Heart Disease: A Blinded Randomized, Controlled Trial 19237438 2009 03 03 2009 03 30 2016 11 25 1098-4275 123 3 2009 Mar Pediatrics Pediatrics Heparin-bonded central venous catheters do not reduce thrombosis in infants with congenital heart disease: a blinded randomized, controlled trial. e453-8 10.1542/peds.2008-1508 Infants with congenital heart disease who require central venous lines are at increased (...) risk of thrombosis. Heparin-bonded catheters provide protection from thrombotic events in some children. However, heparin-bonded catheters may not be as effective in infants =1 year old because of other potential risk factors (smaller vessel size, longer duration of catheter use). No studies have assessed the benefit of heparin-bonded catheters in such specific high-risk populations. The objective of this study was to assess the efficacy of heparin-bonded catheters for preventing thrombosis