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Anti-factor Xa Activity of Enoxaparin for Thromboprophylaxis in Nonsurgical Patients Is Dependent on Body Mass
David Jiméneza,
, Gema Díaza, Ana Iglesiasb, Jesús Césarb, Ángel García-Avellob, David Martíc, Carlos Escobarc, Rafael Vidala, Antonio Sueiroa
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djc_69_98@yahoo.com
Correspondence: Dr D. Jiménez Servicio de Neumología, Hospital Ramón y Cajal Ctra de Colmenar, km 9.100 28034 Madrid, Spain
Correspondence: Dr D. Jiménez Servicio de Neumología, Hospital Ramón y Cajal Ctra de Colmenar, km 9.100 28034 Madrid, Spain
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Jiménez Servicio de Neumología, Hospital Ramón y Cajal Ctra de Colmenar, km 9.100 28034 Madrid, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-10-17" "fechaAceptado" => "2008-03-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155125" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Enoxaparin</span>" 1 => "<span class="elsevierStyleItalic">Thromboprophylaxis</span>" 2 => "<span class="elsevierStyleItalic">Acute medical condition</span>" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155126" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Enoxaparina</span>" 1 => "<span class="elsevierStyleItalic">Tromboprofilaxis</span>" 2 => "<span class="elsevierStyleItalic">Proceso médico agudo</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Thromboprophylaxis with fixed doses of low molecular weight heparin is recommended for hospitalized acutely ill medical patients. The purpose of this study was to assess whether the anti-factor Xa (anti-Xa) activity of enoxaparin prescribed for venous thromboembolism prophylaxis depends on body mass index (BMI) in patients hospitalized for an acute respiratory disease.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">All patients admitted by the respiratory medicine department (January-December 2006) for an acute respiratory disease, and for whom pharmacologic thromboprophylaxis was indicated, were included in the study. Anti-Xa activity was measured 4 hours after administration of enoxaparin on the third day of hospitalization. The primary outcome was anti-Xa activity in relation to BMI.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">One hundred twelve patients were enrolled. Mean anti-Xa activity decreased with each BMI quartile(0.28, 0.23, 0.15 and 0.13 U/mL for quartiles 1, 2, 3, and 4, respectively). In the multivariate analysis, BMI was the only predictor of inadequate anti-Xa activity (odds ratio, 1.14; 95% confidence interval, 10.5-1.24; <span class="elsevierStyleItalic">P</span><.002) after adjustment for age, sex, and serum creatinine concentration. Two episodes of symptomatic proximal deep vein thrombosis were observed in the month after hospitalization; both were in patients who had inadequate anti-Xa activity.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Anti-Xa activity is dependent on BMI in hospitalized acute medical patients receiving enoxaparin for thromboprophylaxis.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Se recomienda la tromboprofilaxis con heparina de bajo peso molecular a dosis fijas en pacientes médicos agudos que requieran ingreso hospitalario. El objetivo de este estudio ha sido determinar si la actividad antifactor Xa de la enoxaparina depende del peso corporal cuando se administra a pacientes hospitalizados por un proceso respiratorio agudo como profilaxis de la enfermedad tromboembólica venosa.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó prospectivamente en el estudio a todos los pacientes ingresados en el Servicio de Neumología entre enero y diciembre de 2006 por un proceso respiratorio agudo con indicación de tromboprofilaxis farmacológica. Se determinó la actividad anti-Xa 4 h después de la administración de la enoxaparina, en el tercer día de ingreso hospitalario. El criterio de evaluación principal fue la actividad anti-Xa en función del índice de masa corporal (IMC).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó a 112 pacientes en el estudio. La actividad anti-Xa media disminuyó a medida que aumentaban los cuartiles de IMC (0,28, 0,23, 0,15 y 0,13 U/ml para los cuartiles 1, 2, 3 y 4, respectivamente). En el análisis multivariable, el IMC fue la única variable predictora de actividad anti-Xa insuficiente (<span class="elsevierStyleItalic">odds ratio</span> = 1,14; intervalo de confianza del 95%, 1,05-1,24; p < 0,002), después de ajustar por la edad, el sexo y la creatinina sérica. Hubo 2 episodios sintomáticos de trombosis venosa profunda proximal en el mes posterior al ingreso hospitalario, ambos en pacientes con actividad anti-Xa insuficiente.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La actividad anti-Xa de la enoxaparina depende del IMC en los pacientes que reciben tromboprofilaxis por un proceso médico agudo que requiera hospitalización.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">A grant to support this research was received from the Society of Pulmonology and Thoracic Surgery of Madrid (NEUMOMADRID).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antithrombotic therapy for venous thromboembolic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H Büller" 1 => "G Agnellli" 2 => "RD Hull" 3 => "TM Hyers" 4 => "MH Prins" 5 => "GE Raskob" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.126.3_suppl.401S" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2004" "volumen" => "126" "paginaInicial" => "401S" "paginaFinal" => "408S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15383479" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of patient weight on the anticoagulant response to adjusted therapeutic dosage of low-molecular-weight heparin for the treatment of venous thromboembolism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S Jo-Anne Wilson" 1 => "K Wilbur" 2 => "E Burton" 3 => "DR Anderson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "48043" "Revista" => array:6 [ "tituloSerie" => "Haemostasis" "fecha" => "2001" "volumen" => "31" "paginaInicial" => "42" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11408748" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. 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| Year/Month | Html | Total | |
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| 2020 October | 15 | 10 | 25 |
| 2020 September | 4 | 9 | 13 |
| 2020 August | 18 | 17 | 35 |
| 2020 July | 17 | 22 | 39 |
| 2020 June | 16 | 8 | 24 |
| 2020 May | 34 | 17 | 51 |
| 2020 April | 30 | 36 | 66 |
| 2020 March | 16 | 12 | 28 |
| 2020 February | 22 | 24 | 46 |
| 2020 January | 19 | 20 | 39 |
| 2019 December | 15 | 17 | 32 |
| 2019 November | 10 | 17 | 27 |
| 2019 October | 14 | 8 | 22 |
| 2019 September | 7 | 16 | 23 |
| 2019 August | 23 | 16 | 39 |
| 2019 July | 13 | 18 | 31 |
| 2019 June | 12 | 19 | 31 |
| 2019 May | 25 | 11 | 36 |
| 2019 April | 27 | 12 | 39 |
| 2019 March | 13 | 27 | 40 |
| 2019 February | 18 | 14 | 32 |
| 2019 January | 9 | 10 | 19 |
| 2018 December | 7 | 9 | 16 |
| 2018 November | 19 | 18 | 37 |
| 2018 October | 18 | 16 | 34 |
| 2018 September | 10 | 9 | 19 |
| 2018 May | 9 | 2 | 11 |
| 2018 April | 3 | 3 | 6 |
| 2018 March | 6 | 4 | 10 |
| 2018 February | 7 | 11 | 18 |
| 2018 January | 6 | 2 | 8 |
| 2017 December | 7 | 10 | 17 |
| 2017 November | 4 | 11 | 15 |
| 2017 October | 3 | 6 | 9 |
| 2017 September | 5 | 10 | 15 |
| 2017 August | 5 | 13 | 18 |
| 2017 July | 0 | 5 | 5 |
| 2017 June | 8 | 27 | 35 |
| 2017 May | 7 | 19 | 26 |
| 2017 April | 2 | 7 | 9 |
| 2017 March | 4 | 23 | 27 |
| 2017 February | 1 | 4 | 5 |
| 2017 January | 4 | 6 | 10 |
| 2016 December | 1 | 12 | 13 |
| 2016 November | 4 | 10 | 14 |
| 2016 October | 3 | 11 | 14 |
| 2016 September | 11 | 13 | 24 |
| 2016 August | 7 | 3 | 10 |
| 2016 July | 12 | 3 | 15 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 126 | 17 | 143 |
| 2015 September | 140 | 13 | 153 |
| 2015 August | 111 | 10 | 121 |
| 2015 July | 93 | 8 | 101 |
| 2015 June | 86 | 12 | 98 |
| 2015 May | 79 | 16 | 95 |
| 2015 April | 103 | 15 | 118 |
| 2015 March | 91 | 12 | 103 |
| 2015 February | 85 | 4 | 89 |
| 2015 January | 103 | 9 | 112 |
| 2014 December | 101 | 5 | 106 |
| 2014 November | 148 | 7 | 155 |
| 2014 October | 164 | 15 | 179 |
| 2014 September | 144 | 6 | 150 |
| 2014 August | 150 | 15 | 165 |
| 2014 July | 161 | 9 | 170 |
| 2014 June | 141 | 8 | 149 |
| 2014 May | 112 | 11 | 123 |
| 2014 April | 117 | 10 | 127 |
| 2014 March | 118 | 9 | 127 |
| 2014 February | 91 | 12 | 103 |
| 2014 January | 99 | 7 | 106 |
| 2013 December | 69 | 11 | 80 |
| 2013 November | 59 | 8 | 67 |
| 2013 October | 99 | 8 | 107 |
| 2013 September | 75 | 8 | 83 |
| 2013 August | 59 | 10 | 69 |
| 2013 July | 66 | 10 | 76 |
| 2013 June | 45 | 9 | 54 |
| 2013 May | 56 | 12 | 68 |
| 2013 April | 30 | 5 | 35 |
| 2013 March | 14 | 2 | 16 |
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