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- Document type:
- Journal Article; Research Support, Non-U.S. Gov't
- Author(s):
- Schellong, SM; Gerlach, HE; Tebbe, U; Haas, S; Melzer, N; Abletshauser, C; Sieder, C; Bramlage, P; Riess, H; Bauersachs, R
- Title:
- Certoparin versus UFH to prevent venous thromboembolic events in the very elderly patient: an analysis of the CERTIFY study.
- Abstract:
- There is an exponential rise of thromboembolic risk with age because of co-morbidities, immobility and pharmacotherapy. We aimed to investigate the benefits and risks of heparin prophylaxis in very elderly patients >=80 years and the type of heparin used in a subgroup analysis of the CERTIFY trial.3,239 patients were randomized to 3,000 U aXa o.d. certoparin or 5,000 IU t.i.d. unfractionated heparin (UFH) for 8-20 days.Patients >=80 years (n=1,365) were more likely to be female, had a lower mean bodyweight, were more frequently using antiplatelets and had a GFR below 30 ml/min/1.73 m(2) more often than patients <80 years (n=1,875). The combined endpoint of proximal DVT, symptomatic non-fatal PE and VTE related death was experience by 5.26% of patients >=80 years versus 3.51% in younger patients (OR 1.53; 95%CI 1.05-2.21; p=0.03). There were no significant differences in both minor (OR 1.11; 95%CI 0.75-1.62) and major (OR 2.53; 95%CI 0.93-6.86) bleeding risks. Certoparin and UFH were equally effective in reducing thromboembolic risk in either age group. The risk of any (OR 0.45; 95%CI 0.26-0.79) and minor bleeding (OR 0.42; 95%CI 0.23-0.78) was reduced with certoparin in the very elderly only. There were more adverse events in elderly patients (OR 1.26; 95%CI 1.1-1.46), but rates were otherwise comparable.The analysis confirmed the increased thromboembolic risk in very elderly patients, but demonstrated no increased bleeding risk. Certoparin and UFH were equally effective and safe with a reduced risk of minor bleeding complications with certoparin in the very elderly.
- Journal title abbreviation:
- Thromb Res
- Year:
- 2011
- Journal volume:
- 128
- Journal issue:
- 5
- Pages contribution:
- 417-21
- Language:
- eng
- Fulltext / DOI:
- doi:10.1016/j.thromres.2011.05.002
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/21658750
- Print-ISSN:
- 0049-3848
- TUM Institution:
- Institut für Experimentelle Onkologie und Therapieforschung
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