Low-molecular-weight or unfractionated heparin in venous thromboembolism: the influence of renal function
Abstract
In patients with acute venous thromboembolism and renal insufficiency, initial therapy with unfractionated heparin may have some advantages over low-molecular-weight heparin. We used the Registro Informatizado de la Enfermedad TromboEmbolica (RIETE) Registry data to evaluate the 15-day outcome in 38,531 recruited patients.
We used propensity score matching to compare patients treated with unfractionated heparin with those treated with low-molecular-weight heparin in 3 groups stratified by creatinine clearance levels at baseline: >60 mL/min, 30 to 60 mL/min, or >30 mL/min. In comparison with low-molecular-weight heparin, initial therapy with unfractionated heparin was associated with a higher mortality and higher rate of fatal pulmonary embolism in patients with creatinine clearance levels >60 mL/min or >30 mL/min, but not in those with levels between 30 and 60 mL/min.