Pharmacologic Prevention Of Venous Thromboembolism In Obese Patients
Kamila Bakirhan, Marianna Strakhan
Published 2012 · Medicine
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Venous thromboembolism, a collective term for pulmonary embolism and deep venous thrombosis accounts for a large amount of mortality and morbidity in hospitalized patients. Obesity has been considered as an important risk factor for the development of venous thromboembolism. Anticoagulation with fixed doses of low molecular weight heparin, anti-factor Xa inhibitors and unfractionated heparin is widely used in hospitals and has shown to be an effective measure in prevention of venous thromboembolism in multiple major randomized, double-blind controlled trials. Appropriate dosing of anticoagulation in obese patients is still controversial, since obese and morbidly obese population of patients is consistently underrepresented or often excluded from most clinical trials, raising a concern for adequacy of standard dosing in this high risk population.
This paper references
The effect of body weight on dalteparin pharmacokinetics A preliminary study
Justin Y Yee (2000)
Biological action of leptin as an angiogenic factor.
M Rocío Sierra-Honigmann (1998)
Risk factors for venous thromboembolism. Circulation 107(23 Suppl 1):I9–I16
Anderson FA (2003)
Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physician Evidence-Based Clinical Practice Guidelines Online Only ArticlesPrevention of VTE in Nonorthopedic Surgical Patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Ches
Michael K. Gould (2012)
Plasma leptin levels are associated with abnormal fibrinolysis in men and postmenopausal women.
Stefan Söderberg (1999)
Impact of Obesity on Drug Metabolism and Elimination in Adults and Children
Margreke J. E. Brill (2012)
Obesity as a risk factor in venous thromboembolism.
Paul D. Stein (2005)
Weight-based dosing of enoxaparin for VTE prophylaxis in morbidly obese, medically-Ill patients.
Matthew T Rondina (2010)
Physicians evidence - based clinical practice guidelines
EA Nutescu (2009)
The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label randomised comparison
D. George Sherman (2007)
Prophylaxis of Venous Thromboembolism Using Two Different Doses of Low-Molecular-Weight Heparin (Nadroparin) in Bariatric Surgery: A Prospective Randomized Trial
Fotis Kalfarentzos (2001)
Risk factors for venous thromboembolism.
John A Heit (2003)
Enoxaparin effect depends on body-weight and current doses may be inadequate in obese patients.
Sven G Frederiksen (2003)
Therapy Insight: adipocytokines in metabolic syndrome and related cardiovascular disease
Yuji Matsuzawa (2006)
Estimating the glomerular filtration rate in obese adult patients for drug dosing.
Manjunath P Pai (2010)
Apixaban versus enoxaparin for thromboprophylaxis after hip replacement.
Michael Rud Lassen (2010)
Influence of skinfold thickness on heparin absorption
Caroline Kroon (1991)
Efficacy and safety of dabigatran etexilate for the prevention of venous thromboembolism following total hip or knee arthroplasty. A meta-analysis.
Sorrel E. Wolowacz (2008)
Enoxaparin for Thromboprophylaxis in Morbidly Obese Patients Undergoing Bariatric Surgery: Findings of the Prophylaxis Against VTE Outcomes in Bariatric Surgery Patients Receiving Enoxaparin (PROBE) Study
Giselle G. Hamad (2005)
Unfractionated Heparin Infusion for Thromboprophylaxis in Highest Risk Gastric Bypass Surgery
Michele F.Shepherd (2004)
Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial
Alexander A. Cohen (2006)
A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. Prophylaxis in Medical Patients with Enoxaparin Study Group.
Meyer Michel Samama (1999)
Physician practices in the management of venous thromboembolism: a community-wide survey.
Fred A. Anderson (1992)
The epidemiology of venous thromboembolism in the community.
John A Heit (2001)
Effects of Obesity on Pharmacokinetics
Georges Cheymol (2000)
Evaluating the Safety and Efficacy of BMI-Based Preoperative Administration of Low-Molecular-Weight Heparin in Morbidly Obese Patients Undergoing Roux-en-Y Gastric Bypass Surgery
Kuldeep Singh (2011)
Drug pharmacokinetics in the obese.
Georges Cheymol (1988)
Continuous Intravenous Heparin Infusion Prevents Peri-operative Thromboembolic Events in Bariatric Surgery Patients
Brian B. Quebbemann (2005)
Thrombosis and obesity: cellular bases.
Roberto Lorenzet (2012)
Apixaban or enoxaparin for thromboprophylaxis after knee replacement.
Michael Rud Lassen (2009)
Subcutaneous abdominal adipose tissue blood flow: variation within and between subjects and relationship to obesity.
Lucinda K M Summers (1996)
Lowmolecular-weight heparins in renal impairment and obesity: available evidence and clinical practice recommendations across medical and surgical settings
EA Nutescu (2009)
Regulation of tissue factor gene expression in obesity.
Fahumiya Samad (2001)
Physicians Evidence-Based Clinical Practice Development : American College of Chest Thrombolytic Therapy Guideline Methodology for Antithrombotic and
Holger J. Schünemann (2008)
Prevalence and trends in obesity among US adults, 1999-2008.
Katherine M. Flegal (2010)
Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients.
Alain Leizorovicz (2004)
Angiogenesis and development of adipose tissue
Valerie Christiaens (2010)
Enoxaparin thromboprophylaxis in gastric bypass patients: extended duration, dose stratification, and antifactor Xa activity.
Marilyn J. Borkgren-Okonek (2008)
Does hepatic steatosis affect drug metabolizing enzymes in the liver?
Christa Buechler (2011)
Correlation between anti-Xa and occurrence of thrombosis and haemorrhage in post-surgical patients treated with either Logiparin (LMWH) or unfractionated heparin. Post-surgery Logiparin Study Group.
Lucienne Bara (1992)
Anti-Xa Levels in Bariatric Surgery Patients Receiving Prophylactic Enoxaparin
Brea O Rowan (2008)
Effect of Obesity on the Pharmacokinetics of Drugs in Humans
Michael J. Hanley (2010)
Visceral Fat Adipokine Secretion Is Associated With Systemic Inflammation in Obese Humans
Luigi Fontana (2007)
Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial
Michael Rud Lassen (2010)
Platelet dysfunction in central obesity.
Giovanni Anfossi (2009)
Dosing in heavy-weight/obese patients with the LMWH, tinzaparin: a pharmacodynamic study.
James W. Hainer (2002)
Dosing frequency of unfractionated heparin thromboprophylaxis: a meta-analysis.
Olivia J. Phung (2011)
Serum alpha 1-acid glycoprotein and the binding of drugs in obesity.
Irma H. Benedek (1983)
The Weight-based Heparin Dosing Nomogram Compared with a Standard Care Nomogram
Robert A Raschke (1993)
Effect of fondaparinux prophylaxis on anti-factor Xa concentrations in patients with morbid obesity.
Larissa A Martinez (2011)
Prevention Of Deep Vein Thrombosis In Medical Patients By Low Dose Subcutaneous Heparin
Jill J. F. Belch (1981)
Rivaroxaban for the prevention of venous thromboembolism after hip or knee arthroplasty. Pooled analysis of four studies.
Alexander G. G. Turpie (2011)
Physicians evidence - based clinical practice guidelines
AC Spyropoulos (2009)
Factor V leiden and morbid obesity in fatal postoperative pulmonary embolism.
Hagan Blaszyk (2000)
High plasma levels of factor VIII and the risk of recurrent venous thromboembolism.
P Hari (2000)
Venous thromboembolism prophylaxis in the medical patient: controversies and perspectives.
Alex C Spyropoulos (2009)
[Anti-factor Xa activity of enoxaparin for thromboprophylaxis in nonsurgical patients is dependent on body mass].
David Jiménez (2008)
The pharmacokinetics and pharmacodynamics of enoxaparin in obese volunteers.
Ger-Jan C M Sanderink (2002)
Oral anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
Walter Ageno (2012)
The Pharmacokinetics of Fondaparinux Sodium in Healthy Volunteers
François Donat (2002)
Overweight, obesity, and the risk of recurrent venous thromboembolism.
Sabine Eichinger (2008)
Dosing in obesity: a simple solution to a big problem.
Phey Yen Han (2007)
Role of adipose tissue in haemostasis, coagulation and fibrinolysis.
Daniël R Faber (2009)
Efficacy and safety of fixed low-dose dalteparin in preventing venous thromboembolism among obese or elderly hospitalized patients: a subgroup analysis of the PREVENT trial.
Nils Kucher (2005)
Venous thromboembolism epidemiology: implications for prevention and management.
John A Heit (2002)
Cardiac remodeling in obesity.
Eleanor Abel (2008)
The influence of serum lipoproteins on the pharmacokinetics and pharmacodynamics of lipophilic drugs and drug carriers.
Kishor M. Wasan (1993)
The Incidence of Clinical Postoperative Thrombosis After Gastric Surgery for Obesity During 16 Years
Staffan Eriksson (1997)
Influence of obesity on drug disposition.
Robert A. Blouin (1987)
Obesity and thrombosis.
Katy A L Darvall (2007)
Fondaparinux vs enoxaparin for the prevention of venous thromboembolism in major orthopedic surgery: a meta-analysis of 4 randomized double-blind studies.
Alexander G. G. Turpie (2002)
Physicians Evidence - Based Clinical Practice Guidelines
SE Wolowacz (2009)
Population Pharmacokinetics and Pharmacodynamics of Rivaroxaban — an Oral, Direct Factor Xa Inhibitor — in Patients Undergoing Major Orthopaedic Surgery
Wolfgang Mueck (2008)
Fondaparinux - data on efficacy and safety in special situations.
Michael Nagler (2012)
Comparison of two low-molecular-weight heparin dosing regimens for patients undergoing laparoscopic bariatric surgery
Erin P. Simone (2008)
Prospective study of BMI and the risk of pulmonary embolism in women.
Christopher Kabrhel (2009)
A Comparison of Two Different Prophylactic Dose Regimens of Low Molecular Weight Heparin in Bariatric Surgery
Donald J. Scholten (2002)
Effect of Prophylactic Dalteparin on Anti-factor Xa Levels in Morbidly Obese Patients After Bariatric Surgery
M. Simoneau (2010)
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Risk factors, risk assessment, and prognosis in patients with gynecological cancer and thromboembolism.
Xindan Wang (2019)
Venous thromboembolism prophylaxis in obese, critically-ill patients: A survey of Ottawa region Intensivists.
Audrey Frenette (2019)
Different manifestations of pulmonary embolism in younger compared to older patients: Clinical presentation, prediction rules and long-term outcomes.
Izabela E Kiluk (2017)
Risk Assessment of Deep Venous Thrombosis and Its Influencing Factors in Burn Patients.
Huan Peng (2019)
Prévention de la thrombose veineuse chez les patients obèses en réanimation Thromboprophylaxis for Overweight Critically Ill Patients
Benjamin Planquette (2015)
Headaches More Common among Epilepsy Sufferers with Neurocysticercosis than Other Structural Brain Lesions.
Erin Saito (2017)
Efficacy and safety of high-dose thromboprophylaxis in morbidly obese inpatients.
Tzu-Fei Wang (2014)
Monitoring of Hypercoagulability by Thromboelastography in Bariatric Surgery
Kristina Kupčinskienė (2017)