No abstract available.
Acute Coronary Syndrome* ; Dalteparin* ; Humans

Although heparin has over the years proven to be a reliable anticoagulant, there are still several undesirable side effects including dyslipidemia. Several recent publications have suggested that a low-molecular-weight heparin(LMWH) is superior to conventional heparin because it causes less side effects and has beneficial effects on lipid parameters. But the results of the study about lipid parameters are controversial. We conducted a prospective study to evaluate the efficacy, safetey and effect of LMWH on lipid parameters as an anticoagulant in hemodialysis therapy. 2500 a x a IU of LMWH(Fragmin ) were given to 51 maintenance hemodialysis patients (age:49.9+/-16.1, M:F=33:18) just before each dialysis for consecutive 12 hemodialysis. And 16 patients out of 51 patients were given for 6 months to compare the changes of lipid parameters with those in 22 patients with conventional heparin. The mean venous compression time and the degree of clot deposition in dialyzer were similar in both LMWH and conventional heparin group. The heparin concentration via anti-factor Xa-specific clotting method (Heptest ) in both groups was similar(0.64+/-0.24 vs 0.54+/-0.18IU/ml at 15 min, 0.32+/-0.13 vs. 0.26+/-0.24 IU/ml at 4 hours after starting hemodialysis). The hematologic parameters such as hemoglobin and platelet count level did not show any differences between the two types of heparin. The level of triglyceride was significantly decreased after 6 month by the LMWH therapy(177.6+/-60.9 vs 145.9+/-85.5mg/dl, P<0.05) but was not changed by the conventional heparin therapy(150.6+/-54.6 vs. 176.6+/-64.6, P=0.16). The level of HDL were significantly changed in both group(32.1+/-11.6 vs. 37.9+/-9.7mg/dl, P<0.05 in LMWH group , 40.4+/-11.9 vs. 33.7+/-7.8mg/dl, P<0.05 in conventional heparin group). The levels of total cholesterol and LDL-cholesterol were decreased in LMWH group but statistically insignificant. We conclude that LMWH is a suitable alternative to unfractionated conventional heparin for anticoagulation therapy and has beneficial effects on the lipoprotein profile in hemodialysis patients.
Cholesterol ; Dalteparin ; Dialysis ; Dyslipidemias ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Lipoproteins ; Platelet Count ; Prospective Studies ; Renal Dialysis* ; Triglycerides

Rectus sheath hematoma (RSH) is an uncommon condition caused by hemorrhage into the rectus sheath. RSH is characterized by abdominal pain and an abdominal mass. This condition is associated with old age, childbirth, abdominal surgery, severe coughing, severe sneezing, anticoagulation therapy, and/or coagulation disorders. We report herein a case of RSH and pelvic cavity hematoma that was induced by dalteparin injection in a 77-year-old woman with pulmonary embolism and deep vein thrombosis, and who was successfully treated by conservative management.
Abdominal Pain ; Aged ; Cough ; Dalteparin* ; Female ; General Surgery ; Hematoma* ; Hemorrhage ; Humans ; Parturition ; Pulmonary Embolism ; Sneezing ; Venous Thrombosis

Rectus sheath hematoma (RSH) is an uncommon condition caused by hemorrhage into the rectus sheath. RSH is characterized by abdominal pain and an abdominal mass. This condition is associated with old age, childbirth, abdominal surgery, severe coughing, severe sneezing, anticoagulation therapy, and/or coagulation disorders. We report herein a case of RSH and pelvic cavity hematoma that was induced by dalteparin injection in a 77-year-old woman with pulmonary embolism and deep vein thrombosis, and who was successfully treated by conservative management.
Abdominal Pain ; Aged ; Cough ; Dalteparin* ; Female ; General Surgery ; Hematoma* ; Hemorrhage ; Humans ; Parturition ; Pulmonary Embolism ; Sneezing ; Venous Thrombosis

PURPOSE: To evaluate the effects and problems of venous thromboembolism (VTE) prophylaxis with a reduced dosage and administration period in Korean total knee arthroplasty (TKA) patients. MATERIALS AND METHODS: We analyzed 135 consecutive TKA patients with three different VTE prophylaxis regimens. Group dalteparin-aspirin (DA) injected dalteparin for the first 2 days, followed by taking aspirin for the next 5 days, Group aspirin (A) was on aspirin and Group dalteparin (D) on dalteparin 7 days postoperatively. We evaluated the incidence of VTE and safety among the 3 groups. RESULTS: Symptomatic deep vein thrombosis was detected in 4 cases (Group DA: 2, Group A: 1, Group D: 1). Pulmonary embolism (PE) was found in 1 case in each group with no fatal PE. Although no major bleeding complications were seen, minor bleeding incidents were detected in 14 cases (Group DA: 2, Group A: 1, Group D: 11), which was significant in Group D. No significant differences were observed in perioperative blood loss, effusion in the knee joint, thigh swelling or oozing on the wound area among the groups except thigh bruising, which developed more frequently in group D. CONCLUSION: The reduced dosage and administration period of VTE prophylactic medicine combined with mechanical prophylaxis for Korean TKA patients showed no fatal PE, but some minor bleeding incidents frequently developed with 7 days of dalteparin injections. We need to adjust the dosage and duration of prophylactic medication deliberately for Korean TKA patients, considering prophylaxis effectiveness and bleeding complication risks.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Aspirin ; Dalteparin ; Hemorrhage ; Humans ; Incidence ; Knee ; Knee Joint ; Pulmonary Embolism ; Thigh ; Venous Thromboembolism ; Venous Thrombosis

dalteparin.METHODS: The 162 eligible patients with gynecologic cancers who were treated with either dalteparin (n=60) or rivaroxaban (n=102) were reviewed. The primary outcome was a composite event, which included recurrence or clinically relevant bleeding events during the therapeutic period. Secondary outcomes were recurrence, clinically relevant bleeding events, and mortality.RESULTS: During the therapeutic period, there were no significant differences between the groups in the proportion of composite events, recurrence, or clinically relevant bleeding. Multivariate analysis using the Cox proportional hazards model also showed no significant difference in the number of composite events and clinically relevant bleeding between the groups. In the rivaroxaban group, 44.0% of patients experienced gastrointestinal bleeding and 24.0% experienced urinary tract bleeding. In the dalteparin group, bleeding was most common in the urinary tract (44.4%) and at the injection site (22.2%).CONCLUSION: In this study, although there were no significant differences in effectiveness or safety between the rivaroxaban and dalteparin groups, rivaroxaban use was associated with a higher rate of clinically relevant bleeding than dalteparin. Therefore, caution should be taken when prescribing rivaroxaban for gynecologic cancer-associated VTE and bleeding events should be carefully monitored.]]>
Anticoagulants ; Dalteparin ; Hemorrhage ; Heparin ; Humans ; Mortality ; Multivariate Analysis ; Proportional Hazards Models ; Recurrence ; Rivaroxaban ; Urinary Tract ; Venous Thromboembolism

BACKGROUND: Venous thromboembolism (VTE) is a common and life-threating condition in cancer patients. Low molecular weight heparins (LMWH), such as dalteparin, are recommended in the treatment of VTE. Also, rivaroxaban, an orally administered direct factor Xa inhibitor, was approved for the treatment of VTE. It showed similar efficacy to standard therapy (LMWH or warfarin) and was associated with significantly lower rates of major bleedings. However, in the real world, bleeding has been reported to occur frequently in cancer patient receiving rivaroxaban. The goal of this research was to analyze bleeding risks between rivaroxaban and dalteparin for treatment of VTE in cancer patients. METHODS: Medical records of oncology patients who were treated with rivaroxaban or dalteparin for VTE from July 2012 to June 2014 were retrospectively reviewed. Data collected were as follows: age, sex, weight, height, cancer types and stages, ECOG (eastern cooperative oncology group) PS (performance score), VTE types, concurrently used medications, study drug information (dose and duration of therapy), INR (international normalized ratio), PT (prothrombin time), and platelet counts. Bleeding was classified into major bleedings, clinically relevant non-major bleedings, and minor bleedings. RESULTS: A total of 399 patients were included in the study. Of these patients, 246 were treated with rivaroxaban and 153 with dalteparin. Bleeding rates were significantly higher in the rivaroxaban group than in the dalteparin group (adjusted odds ratio (AOR) 2.09, 95% CI 1.22-3.60) after adjusting for confounders. In addition, rivaroxaban remained independently associated with 1.78-fold (95% CI 1.14-2.76) shorter time to bleeding compared to dalteparin after adjusting other factors known to be associated with poor outcomes. CONCLUSION: This study suggested that rivaroxaban was associated with an increased risk of bleedings in cancer patients.
Dalteparin* ; Factor Xa ; Hemorrhage* ; Heparin, Low-Molecular-Weight ; Humans ; International Normalized Ratio ; Medical Records ; Odds Ratio ; Platelet Count ; Retrospective Studies ; Rivaroxaban* ; Venous Thromboembolism*

BACKGROUND AND OBJECTIVES: The therapeutic efficacy of combined platelet glycoprotein IIb/IIIa receptor blocker with low molecular weight heparin (LMWH) is unknown for patients with acute myocardial infarction (AMI) and who underwent percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: A total of 140 patients with AMI and who underwent high-risk PCI was divided into two groups: UFH (group I: 70 patients, 58.7+/-10.5 years of age), and dalteparin (group II: 70 patients, 59.6+/-9.8 years of age). The major adverse cardiac events (MACE) during hospitalization and during the 4 years after PCI were evaluated. RESULTS: The baseline clinical characteristics and angiographic characteristics were not different between the two groups. There were 62.9% totally occluded lesions with thrombus in both groups. Procedural success was achieved for 91.4% of the group I patients and for 90.0% of the group II patients. Any bleeding and hemorrhagic events were not different between the two groups. No significant intracranial bleeding was observed in both groups. The number of in-hospital MACEs was 7 (10.0%) in group I and 4 (5.7%) in group II. Four-year clinical follow-up was performed for 97% of the patients. As a result of the MACEs during the 4 years after PCI, death occurred in 6 (8.6%) patients in group I and in 7 (10.0%) patients in group II. Myocardial infarction occurred in 4 (5.7%) and 4 (5.7%) patients, respectively, target vessel revascularizations were done in 23 (32.9%) and 16 (22.9%) patients, respectively, and coronary artery bypass surgery was done in 3 (4.3%) and 1 (1.4%) patients, respectively. Overall, MACEs occurred in 33 (47.1%) patients of group I and in 26 (35.1%) patients of group II during the 4-year clinical follow-up (p=0.23). CONCLUSION: The long-term clinical outcome of dalteparin combined with abciximab is comparable with that of UFH plus abciximab for the high risk patients with AMI who receive PCI.
Blood Platelets ; Coronary Artery Bypass ; Dalteparin* ; Follow-Up Studies ; Glycoproteins ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Prognosis ; Thrombosis

BACKGROUND AND OBJECTIVES: Platelet activation and aggregation, with resultant arterial thrombus formation, play pivotal roles in the pathophysiology of acute coronary syndrome (ACS). The efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin, or low molecular heparin (LMWH), in the management of ACS were evaluated. SUBJECTS AND MEHTODS: One hundred seventeen patients (60.8+/-10.9 years, 76 male), with unstable angina or non-ST elevation myocardial infarction, who had ST-T changes and elevated troponin, were divided into 4 groups : Group I (n=30 : heparin alone), Group II (n=28 : LMWH, dalteparin alone), Group III (n=29 : tirofiban combined with heparin) and Group IV (n=30 : tirofiban with LMWH). The major adverse cardiac events (MACE) among the 4 groups, during 6-month clinical follow-ups, were compared. RESULTS: Percutaneous coronary intervention, or a coronary artery bypass graft, was performed in 23, 19, 19 and 22 patients from Groups I, II, III and IV, respectively (p=0.87). A minor bleeding complication developed in 2 (6.7%), 1 (3.6%), 1 (3.4%) and 2 patients (6.7%) in groups I, II, III and IV, respectively (p=0.79). During the six-month follow-up MACE occurred in 7 (30.4%), 6 (31.6%), 3 (15.8%) and 4 patients (18.2%) in groups I, II, III and IV, respectively (p=0.02 : Group I and II vs. Group III and IV). CONCLUSION: Tirofiban combined with LMWH is safe and may improve the long-term prognosis of patients with ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Angioplasty ; Blood Platelets* ; Coronary Artery Bypass ; Dalteparin ; Follow-Up Studies ; Glycoproteins* ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Thrombosis ; Transplants ; Troponin

Despite improvements in surgical technique, immunosuppressive therapy, and follow-up care, a considerable number of patients with kidney transplants die as a consequence of sepsis and throm-boembolism. The incidence of thromboembolism is higher in patients older than 40 years of age. Prominent among these is an increased incidence of acute myocardial infarction(AMI) in patients receiving corticosteroids. We encountered a rare case that septic shock due to artificial abortion, ARF, and DIC complicated by AMI. A 25-year-old female complained of fever, and watery diarrhea. She was emmergently admitted due to shock. Physical examination demonstrated hypotension and fever. WBC count was 45,300/mL. Elevated FDP, D dimer, CK with dominance of the MB isoenzyme, and troponin-I. EKG showed ST segment elevation in leads aVF, V3-V6. She was treated with cefuroxime, netilmycin, and dalteparin. Cultures obtained from the sputum, urine, and blood did not yield any microorganisms. Although sepsis could not be confirmed, sepsis was highly suspected from the clinical features. This is a rare case in which septic shock, ARF, and DIC complicated by AMI in a young female renal allograft patient. Since AMI in the absence of underlying conditions has been rarely described, we wish to bring attention to the diagnosis of this disorder in a young female allograft recipient and without any other predisposing abnormality.
Adrenal Cortex Hormones ; Adult ; Allografts* ; Cefuroxime ; Dacarbazine ; Dalteparin ; Diagnosis ; Diarrhea ; Electrocardiography ; Female ; Fever ; Follow-Up Studies ; Humans ; Hypotension ; Incidence ; Kidney ; Kidney Transplantation ; Myocardial Infarction* ; Physical Examination ; Sepsis* ; Shock ; Shock, Septic ; Sputum ; Thromboembolism ; Troponin I