Are low molecular weight heparins preferred to unfractionated heparin in people with renal impairment for treatment indications?

Source: South West Medicines Information and Training Area: Evidence > Medicines Q & A . The American College of Chest Physicians (ACCP), National Institute for Health and Clinical Excellence (NICE) and British Society of Haematology (BSH) suggest the use of unfractionated heparin (UFH) may be preferred over low molecular weight heparins (LMWHs) for treatment indications in patients with severe renal impairment (RI) i.e. a CrCl of <30ml/min. . Important advantages of UFH compared to LMWHs are that its renal excretion is minimal, it has a relatively short half-life and its effects can be easily monitored by aPTT and rapidly reversed by protamine. . However, studies comparing LMWHs with UFH have failed to demonstrate statistically significant differences in the incidence of bleeding. The use of UFH was associated with a significantly higher risk of fatal PE compared with LMWH in the RIETE study. . Treatment doses of some LMWHs have been used in patients with RI, however caution is required when using any LMWH in patients with any degree of ...
Source: NeLM - Cardiovascular Medicine - Category: Cardiology Source Type: news