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Published on: February 28, 2012

LMWH for perioperative anticoagulation in patients on chronic warfarin therapy

Luke M Heuts1, Beth M McLendon Arvik, Dawn E Cender

  • 1Nash General Hospital, 2460 Curtis Ellis Drive, Rocky Mount, NC 27804-2237, USA. lmheuts@nhcs.org

The Annals of Pharmacotherapy
|April 29, 2004
PubMed

Insights

Low-molecular-weight heparin (LMWH) shows promise for perioperative anticoagulation in warfarin patients. However, more research is needed to confirm its efficacy and safety as a bridge therapy.

Area of Science:

  • Pharmacology
  • Cardiology
  • Thrombosis Management

Background:

  • Warfarin is a common oral anticoagulant.
  • Perioperative management requires careful consideration of anticoagulation.
  • Bridging anticoagulation is often necessary during warfarin interruption.

Purpose of the Study:

  • To review current data on low-molecular-weight heparin (LMWH) use.
  • To evaluate LMWH for perioperative anticoagulation.
  • To assess LMWH in patients on chronic warfarin therapy.

Main Methods:

  • Literature review of guidelines and MEDLINE search (1996-2003).
  • Included studies on heparin, LMWH, warfarin, and perioperative care.
  • Focused on enoxaparin and dalteparin efficacy and safety.

Main Results:

  • Heparin is the standard bridging agent.
  • Low-molecular-weight heparins (LMWHs) are also utilized.
  • Enoxaparin and dalteparin have been evaluated.

Conclusions:

  • Published studies indicate LMWH efficacy and safety.
  • Further data are required to fully support LMWH as a bridging therapy.
  • Evidence for LMWH in this context is still evolving.
Abstract

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