Low molecular weight heparin (parnaparin) for cardioembolic events prevention in patients with atrial fibrillation undergoing elective electrical cardioversion: a prospective cohort study

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• 作者：Giulia Angeloni (1) (2)
  Silvia Alberti (3)
  Enrico Romagnoli (2)
  Alberto Banzato (4)
  Marco Formichi (5)
  Umberto Cucchini (6)
  Vittorio Pengo (6)
  
• 关键词：Atrial fibrillation ; Electrical cardioversion ; Cardioembolism ; Parnaparin
• 刊名：Internal and Emergency Medicine
• 出版年：2011
• 出版时间：April 2011
• 年：2011
• 卷：6
• 期：2
• 页码：117-123
• 全文大小：198KB
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• 作者单位：Giulia Angeloni (1) (2)
  Silvia Alberti (3)
  Enrico Romagnoli (2)
  Alberto Banzato (4)
  Marco Formichi (5)
  Umberto Cucchini (6)
  Vittorio Pengo (6)
  
  1. Department of Heart and Vessels, Careggi Hospital, University of Florence, Florence, Italy
  2. Department of Cardiovascular Diseases, Sacred Heart Catholic University, Rome, Italy
  3. Research Laboratory, Sacred Heart Catholic University, Rome, Italy
  4. Cardiologia Oncologica, Veneto Region Institute of Oncology, Padua, Italy
  5. Department of Cardiology, Civil Hospital, Este, Italy
  6. Clinical Cardiology, Thrombosis Centre, University of Padua School of Medicine, Padua, Italy
  

文摘

Systemic thromboembolism is a severe complication in patients undergoing electrical cardioversion (ECV) for atrial fibrillation (AF). Vitamin K antagonists greatly reduce the risk of thromboembolic events, but the administration scheme before ECV is troublesome as difficulties in reaching and maintaining the target therapeutic range for 3?weeks often delay the restoration and likelihood of maintaining sinus rhythm. Low molecular weight heparins (LMWHs) do not need dose adjustment, and may be preferable in this clinical setting. In this multicentre study, the LMWH parnaparin was used at a dose of 85?anti-factor?Xa?U/kg b.i.d. 2?weeks before and 3?weeks after ECV of AF. In an intention to treat analysis of 102 patients, there was no systemic thromboembolism or major bleeding (0%, 95% CI 0-.6). Two clinically relevant non-major bleeds (2.5%, 95% CI 0.7-.8) and three minor bleeds (3.8%, 95% CI 1.3-0.6) were recorded. No heparin-induced thrombocytopenia or other major adverse events were recorded. Parnaparin appears effective and safe for thromboprophylaxis of elective ECV in patients with AF.