caa a22 4500 463255836 CHVBK 20180405153354.0 cr unu---uuuuu 170326e20070701xx s 000 0 eng 10.1007/s00277-007-0282-x doi (NATIONALLICENCE)springer-10.1007/s00277-007-0282-x Suboptimal doses of low molecular weight heparin and acute venous thromboembolism. Data from the RIETE registry [Elektronische Daten] [Ma. Bruscas, José Nieto, Monserrat Perez-Pinar, Luciano López-Jiménez, Carmen Fernández-Capitán, Francisca López-Chuliá, Ma. Orue-Lecue] The objective was to assess the use of suboptimal doses (60-149UI kg−1 day−1) of low molecular weight heparin (LMWH) in the treatment of acute venous thromboembolism (VTE) in actual clinical practice and to evaluate the outcomes compared to standard doses (≥150UI kg−1 day−1). Retrospective analysis of data from a multicenter registry of patients with VTE (RIETE; Registro Informatizado de Enfermedad TromboEmbólica). Patient characteristics, antithrombotic treatments, and 3-month outcomes were analyzed. We studied 12,302 patients with VTE; 10,524 patients were treated initially only with LMWH; 1,547 patients received suboptimal LMWH (mean = 122UI kg−1 day−1), and 8,977 patients received full-dose LMWH (mean = 191UI kg−1 day−1). The suboptimal group included significantly more patients with recent major bleeding, weight more than 100kg, raised creatinine, or deep vein thrombosis. No significant differences in mortality rate (7.7 vs 7.8%), VTE recurrence (2.7 vs 2.3%), or fatal hemorrhage (0.6 vs 0.6%) occurred between the suboptimal and the standard group. Major bleeding episodes occurred more frequently in the patients with pulmonary embolism treated with suboptimal LMWH (4.5 vs 2.4%; p = 0.02). In the multivariate analysis, after adjusting for bleeding risk factors, major hemorrhage was not associated with the heparin dose. Suboptimal doses of LMWH are used in actual clinical practice in a reduced group of patients at an outcome rate not very different to that of standard doses. Bleeding episodes depend more on the patient's characteristics than on the LMWH dose. Randomized trials should be performed to corroborate these results. Springer-Verlag, 2007 Venous thromboembolism nationallicence Low molecular weight heparin nationallicence Suboptimal dose nationallicence Hemorrhage nationallicence Outcome nationallicence Bruscas Ma Servicio de Medicina Interna, Hospital Virgen de la Luz, 16002, Cuenca, Spain aut Nieto José Servicio de Medicina Interna, Hospital Virgen de la Luz, 16002, Cuenca, Spain aut Perez-Pinar Monserrat Servicio de Medicina Interna, Hospital Virgen de la Luz, 16002, Cuenca, Spain aut López-Jiménez Luciano Internal Medicine, Hospital Provincial Reina Sofía, Cordova, Spain aut Fernández-Capitán Carmen Internal Medicine, Hospital Universitario La Paz, Madrid, Spain aut López-Chuliá Francisca Hematology, Hospital Arnau de Vilanova, Valencia, Spain aut Orue-Lecue Ma Hematology, Hospital de Navarra, Navarra, Spain aut Annals of Hematology Springer-Verlag 86/7(2007-07-01), 519-526 0939-5555 86:7<519 2007 86 277 https://doi.org/10.1007/s00277-007-0282-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00277-007-0282-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bruscas Ma Servicio de Medicina Interna, Hospital Virgen de la Luz, 16002, Cuenca, Spain aut NATIONALLICENCE 700 1- Nieto José Servicio de Medicina Interna, Hospital Virgen de la Luz, 16002, Cuenca, Spain aut NATIONALLICENCE 700 1- Perez-Pinar Monserrat Servicio de Medicina Interna, Hospital Virgen de la Luz, 16002, Cuenca, Spain aut NATIONALLICENCE 700 1- López-Jiménez Luciano Internal Medicine, Hospital Provincial Reina Sofía, Cordova, Spain aut NATIONALLICENCE 700 1- Fernández-Capitán Carmen Internal Medicine, Hospital Universitario La Paz, Madrid, Spain aut NATIONALLICENCE 700 1- López-Chuliá Francisca Hematology, Hospital Arnau de Vilanova, Valencia, Spain aut NATIONALLICENCE 700 1- Orue-Lecue Ma Hematology, Hospital de Navarra, Navarra, Spain aut NATIONALLICENCE 773 0- Annals of Hematology Springer-Verlag 86/7(2007-07-01), 519-526 0939-5555 86:7<519 2007 86 277 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer