Here are a few articles about it - I was given lovenox for a few days once when my INR was around 1.8
From:
http://www.blackwellpublishing.com/isth2003/abstract.asp?id=10045
From:
http://www.vapbm.org/criteria/enoxaparincriteria.pdf
From:
http://pharmacy.rutgers.edu/pharm_pract/470/2003.10.29-Article.pdf
In general about lovenox - not specifically about heart valves articles-
From:
http://www.pslgroup.com/dg/1D059A.htm
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DG DISPATCH - AAN: Subcutaneous low molecular weight heparin safe and cost-effective
By Richard Robinson
Special to DG News
SAN DIEGO, CA -- May 5, 2000 -- Use of subcutaneous low molecular weight heparin instead of intravenous unfractionated heparin during transition to oral anticoagulant therapy can save thousands of dollars per patient, according to new research.
The findings from the study, "Subcutaneous low molecular weight heparin versus intravenous unfractionated heparin in patients converting to long-term anticoagulation: Is it cost effective?" were presented Thursday (May 4) at the 52nd Annual Meeting of the American Academy of Neurology, held in San Diego, CA.
David Tong, MD, and colleagues at the Stanford Stroke Center, in Palo Alto, CA, compared the safety and cost of these two treatments in patients with cerebrovascular disease who required heparin prior to a switch to oral anticoagulant therapy.
Patients were otherwise medically stable, and except for the need for intravenous anticoagulant therapy, did not require hospitalization.
Comparison of charts for 56 patients receiving intravenous unfractionated heparin and 39 patients receiving subcutaneous low molecular weight heparin showed that there was no difference in the bleeding rates or other complications between the two treatments.
Cost analysis showed the average per-patient cost for intravenous unfractionated heparin was $613 per day, compared to $40 per day for subcutaneous low molecular weight heparin.
"Thus, for a five-day in-patient hospitalization, the cost savings associated with subcutaneous low molecular weight heparin versus intravenous unfractionated heparin was at least $2865 per patient, without any increase in morbidity or complications," said Dr. Tong.
An addition benefit, he noted, is that the subcutaneous injections could be given by a visiting nurse, a caregiver, or even the patients themselves, with proper training.
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DG DISPATCH - ASH: Enoxaparin Beneficial In Patients With Increased Thromboembolic Risk
By Angela Lorio
Special to DG News
NEW ORLEANS, LA -- December 7, 1999 -- Enoxaparin has been found to be a better treatment than heparin for medical patients at increased-to-high risk of blood clots, according to the results of a recent study.
Investigators have concluded that the advantage of enoxaparin over unfractionated heparin (UFH) seems to increase with higher levels of thrombotic risk. In terms of safety, there were fewer adverse events and fewer bleeding episodes associated with enoxaparin, announced lead investigator Franz-Job Harenberg, MD, Head of the Department of Hemostaseology and Professor of Internal Medicine at the University of Mannheim/Heidelberg, in Mannheim, Germany.
The study, ?Enoxaparin Is Superior To Unfractionated Heparin In The Prevention Of Thromboembolic Events In Medical Patients At Increased Thromboembolic Risk,? was presented at the 41st Annual Meeting of American Society of Hematology being held in New Orleans, LA, December 3rd through 7th.
The low molecular-weight heparin, enoxaparin, has been associated with a significant reduction in the incidence of thromboembolic events. Questions remained, however, about its efficacy in non-surgical patients at increased-to-high risk, the investigators noted.
German investigators analyzed data from patients with severe respiratory disease, severe heart failure and acute ischemic stroke. The investigators randomized 439 patients to receive either 40 mg enoxaparin qd and 439 patients to receive 5000 IU unfractionated heparin (UFH) tid. Only 630 patients - 327 from enoxaparin group and 303 from the UFH group - were eligible for efficacy analysis. The main reason for study exclusion was because venography could either not be evaluated or performed.
Results of the study showed that thromboembolic events with subsequent death occurred in 15.6 percent of the patients in the enoxaparin group compared with 22.1 percent in the UFH group. The risk of developing a blood clot was highest among patients with acute ischemic stroke, followed by patients with severe heart failure and severe respiratory disease.
Bleeding events occurred in eight patients in the enoxaparin group as compared to 14 patients in the UFH group. These events were characterized as major in only two enoxaparin patients and one UFH patient. Patients treated with enoxaparin also experienced fewer adverse effects as compared to UFH (9.1 percent versus 196 percent; P<0.001).
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