Prevention of venous thromboembolism in medical patients with enoxaparin: a subgroup analysis of the MEDENOX study
Prevention of venous thromboembolism in medical patients with enoxaparin: a subgroup analysis of the MEDENOX study
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DOI：
10.1097/00001721-200306000-00004
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发表时间：
2003-06-01
影响因子：
1.1
通讯作者：
Turpie, AGG
中科院分区：
文献类型：
--
作者：
Alikhan, R;Cohen, AT;Turpie, AGG
使用依诺肝素的内科患者（MEDENOX）试验是一项随机、安慰剂对照研究，确定了急性病、固定、一般内科患者发生静脉血栓栓塞（VTE）的风险以及低分子量肝素依诺肝素预防血栓形成的疗效。我们进行了一项事后分析，以评价40 mg依诺肝素每日一次对不同类型急性医学疾病（心力衰竭、呼吸衰竭、感染、风湿性疾病和炎症性肠病）和预定风险因素（慢性心脏和慢性呼吸衰竭、年龄、不动、既往VTE和癌症）的MEDENOX患者结局的影响。主要结局是第1 - 14天发生记录的VTE。在亚组中，40 mg依诺肝素与安慰剂相比，VTE的相对风险降低[95%置信区间（CI）]为：急性心力衰竭，0.29（95% CI，0.10-0.84）;急性呼吸衰竭，0.25（95%CI，0.10-0.65）;急性感染性疾病，0.28（95%CI，0.09-0.81）;和急性风湿性疾病，0.48（95%CI，0.11-2.16）。在预先定义的风险因素亚组中，VTE的相对风险降低为：慢性心力衰竭，0.26（95% CI，0.08-0.92）;慢性呼吸衰竭，0.26（95% CI，0.10-0.68）;年龄，0.22（95% CI，0.09-0.51）;不动，0.53（95% CI，0.14-1.72）;既往VTE，0.49（95% CI，0.15-1.68）;和癌症，0.50（95% CI，0.14-1.72）。依诺肝素的有益作用扩展到广泛的急性疾病患者。(C)2003年利平科特威廉姆斯威尔金斯。
The Medical Patients with Enoxaparin (MEDENOX) trial was a randomized, placebo-controlled study that defined the risk of venous thromboembolism (VTE) in acutely ill, immobilized, general medical patients and the efficacy of the low-molecular-weight heparin, enoxaparin, in preventing thrombosis. We performed a post-hoc analysis to evaluate the effect of 40 mg enoxaparin once daily on MEDENOX patient outcome in different types of acute medical illness (heart failure, respiratory failure, infection, rheumatic disorder and inflammatory bowel disease) and pre-defined risk factors (chronic heart and chronic respiratory failure, age, immobility, previous VTE and cancer). The primary outcome was the occurrence of documented VTE between days 1 and 14. The relative risk reduction [95% confidence intervals (CI)] for VTE comparing 40 mg enoxaparin with placebo in the subgroups were: acute heart failure, 0.29 (95% CI, 0.10-0.84); acute respiratory failure, 0.25 (95% CI, 0.10-0.65); acute infectious disease, 0.28 (95% CI, 0.09-0.81); and acute rheumatic disorder, 0.48 (95% CI, 0.11-2.16). The relative risk reduction for VTE in the pre-defined risk factor subgroups were: chronic heart failure, 0.26 (95% Cl, 0.08-0.92); chronic respiratory failure, 0.26 (95% CI, 0.10-0.68); age, 0.22 (95% CI, 0.09-0.51); immobility, 0.53 (95% CI, 0.14-1.72); previous VTE, 0.49 (95% CI, 0.15-1.68); and cancer, 0.50 (95% CI, 0.14-1.72). The beneficial effects of enoxaparin extend to a wide range of acutely ill medical patients. (C) 2003 Lippincott Williams Wilkins.