Association of outcomes and anti-Xa levels in the treatment of pediatric venous thromboembolism.
Pediatr Blood Cancer
; 64(11)2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28521068
ABSTRACT
BACKGROUND:
There are few data in the pediatric population evaluating the relationship between measured anti-Xa levels during enoxaparin therapy and thrombotic outcomes.OBJECTIVE:
To determine whether there is a difference in outcomes in children who receive enoxaparin with mean anti-Xa levels between 0.45 and 0.79 unit/ml (low therapeutic range) versus between 0.80 and 1.05 unit/ml (high therapeutic range) throughout their course of their treatment.METHODS:
We retrospectively identified subjects with uncomplicated venous thromboembolism treated with enoxaparin.RESULTS:
Of 69 patients with any response to therapy, 48 (70%) had mean anti-Xa levels in the low therapeutic range and 21 (30%) had mean anti-Xa levels in the high therapeutic range. Of 20 patients with no documented response to therapy, 13 (65%) had mean anti-Xa levels in the low therapeutic range and 7 (35%) had mean anti-Xa levels in the high therapeutic range. Forty-eight (79%) of the 61 patients with low-range mean anti-Xa level had any response to therapy. Twenty-one (75%) of the 28 patients with high-range mean anti-Xa level had any response to therapy. Chi-square test (P = 0.080) and logistic regression (OR = 1.23, P = 0.70) demonstrated no significant association between mean anti-Xa range (lower vs. upper) and therapy response.CONCLUSIONS:
There was no statistically significant difference between low-range versus high-range mean anti-Xa levels and thrombus resolution. Empiric clinical practices of targeting anti-Xa levels in the higher therapeutic range to achieve better outcomes may not be warranted.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Biomarcadores
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Enoxaparina
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Tromboembolia Venosa
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Inibidores do Fator Xa
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Anticoagulantes
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article