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Study Finds Heparin Complication Rate Lower than Reported

Heparin a 'reasonable' choice over enoxaparin in aneurysmal subarachnoid hemorrhage

FRIDAY, Jan. 9 (HealthDay News) -- Patients with aneurysmal subarachnoid hemorrhage who are treated with heparin may not be at higher risk of heparin-induced thrombocytopenia type II (HIT II) than those treated with enoxaparin, according to research published in the January issue of the Journal of Neurosurgery.

Grace H. Kim, M.D., of Columbia University College of Physicians & Surgeons in New York City, and colleagues analyzed data from 300 patients with aneurysmal subarachnoid hemorrhage (aSAH) who were treated with heparin or the low-molecular-weight heparin enoxaparin for thromboprophylaxis. Up to half of patients who develop HIT II have thrombotic complications, including stroke, myocardial infarction and limb amputation.

The researchers report that 166 patients received heparin, and 134 received enoxaparin. Sixteen patients out of the total group developed HIT II (5.3 percent). Of those treated with heparin or enoxaparin, 4.8 percent and 6 percent developed HIT II, respectively, the investigators found. However, the difference in risk between the groups was not significant, the authors note.

"In this study, we found that the rate of HIT II among patients with aSAH may actually be lower than previously reported (5.3 versus 15 percent). We have also shown that using enoxaparin in the place of heparin for thromboprophylaxis in patients already exposed to heparin has no therapeutic benefit," the authors conclude. "In light of our findings and the much higher cost of enoxaparin, we conclude that it is reasonable to use heparin rather than enoxaparin for thromboprophylaxis in patients with aSAH."

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