Inverse relationship of bleeding risk with clot burden during pulmonary embolism treatment with LMW heparin

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• 作者：Chen Wang ; Zhenguo Zhai ; Yuanhua Yang ; Zhaozhong Cheng ; Kejing Ying ; Lirong Liang ; Huaping Dai ; Kewu Huang ; Weixuan Lu ; Zhonghe Zhang ; Xiansheng Cheng ; Ying Hu Shen ; Bruce L. Davidson and for China National Venous Thromboembolism (VTE) Study Group
• 刊名：The Clinical Respiratory Journal
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：10
• 期：5
• 页码：596-605
• 全文大小：140K
• ISSN：1752-699X

文摘

Clinically relevant bleeding occurs three times as frequently as recurrent venous thromboembolism in the modern early treatment of pulmonary embolism (PE) with fixed-dose, unmonitored anticoagulants. Unfractionated heparin (UFH) is monitored and adjusted to assure efficacy and minimize bleeding risk, but low molecular weight heparin (LMWH) is not. PE requires more anticoagulant than isolated deep venous thrombosis. Speculating that PE with low clot burden could lead to excess bleeding with unadjusted LMWH treatment but not with UFH, we compared PE patients receiving either UFH or LMWH with high and low clot burden for clinically significant bleeding in an observational study.