A comparative double-blind, randomised trial of a new second generation LMWH (bemiparin) and UFH in the prevention of post-operative venous thromboembolism. The Bemiparin Assessment group.

:A randomised, prospective, double-blind trial was performed, to compare the safety and efficacy of a new low-molecular-weight heparin (LMWH) Bemiparin and standard unfractionated heparin (UFH), for the prophylaxis of postoperative venous thromboembolism. 300 patients scheduled to undergo elective hip arthroplasty were included. The principal outcome measures were the incidence of thromboembolic events and bleeding complications. 149 patients received 3,500 anti-Xa IU of bemiparin plus a placebo injection daily and 149 patients received 5,000 IU of UFH twice a day. The two groups were similar with respect to factors likely to affect the risk of developing post-operative venous thromboembolism (VTE) and risk of bleeding events. During the post-operative period, 34 patients developed VTE complications; 9 (7.2%) in the bemiparin group and 25 (18.7%) in the UFH group. VTE in the two groups was statistically significant (OR of 2.96; 95% CI 1.32-6.62 and p = 0.01). There were no significant differences in the frequency of bleeding complications: major bleeding requiring discontinuation of prophylaxis, (OR 1.21; 95% CI 0.36-4.05; p = 1.00), the measured median operative blood loss (p = 0.77) or the median postoperative drain loss (p = 0.97), and the number of patients who developed wound haematoma (OR 0.87; 95% CI 0.31-2.46; p = 1.00). A comparison of coagulation parameters on the preoperative day with post-operative day 2 +/- 1, day 6 +/- 1 and day of discharge showed a significantly higher AT concentration, anti-factor Xa activity and TFPI levels in the bemiparin group when compared with UFH. This study demonstrates that bemiparin, in a single daily subcutaneous dose of 3,500 anti-Xa IU in high risk patients undergoing hip arthroplasty is more effective than UFH administered twice daily at a dose of 5,000 IU in the prevention of postoperative VTE. Both agents are equally safe.

Kakkar VV ，Howes J ，Sharma V ，Kadziola Z ... -  《THROMBOSIS AND HAEMOSTASIS》

A prospective observational study on the effectiveness and safety of bemiparin, first dose administered 6 h after knee or hip replacement surgery.

Abad JI ，Gómez-Outes A ，Martínez-González J ，Rocha E ，Bemiparin 6 Hours After Surgery Study Group ... -  《ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY》

Optimal dosing of bemiparin as prophylaxis against venous thromboembolism in surgery for cancer: an audit of practice.

Balibrea JL ，Altimiras J ，Larruzea I ，Gómez-Outes A ，Martínez-González J ，Rocha E ，Bemiparin Cooperative Study Group in Surgery for Cancer ... -  《-》

[Complications and risks associated with an anticoagulation therapy combining low molecular weight heparin and Warfarin after total replacement of large joints--our experience].

Míka P ，Behounek J ，Skoták M ，Nevsímal L ... -  《Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca》

Prevention of major venous thromboembolism following total hip or knee replacement: a randomized comparison of low-molecular-weight heparin with unfractionated heparin (ECHOS Trial).

Haas S ，Breyer HG ，Bacher HP ，Fareed J ，Misselwitz F ，Victor N ，Weber J ，ECHOS Trial Group ... -  《INTERNATIONAL ANGIOLOGY》