WEDNESDAY, Dec. 28 (HealthDay News) -- Severely ill hospital
patients are at high risk for developing potentially fatal blood
clots, and often wear compression stockings and/or take blood
thinners to help lower this risk.
However, adding the blood thinner Lovenox (enoxaparin) to the
mix does not reduce their chances of dying from a blood clot,
according to research appearing in the Dec. 29 issue of the
New England Journal of Medicine.
In the new study, almost 4,200 patients received Lovenox plus
compression hose and more than 4,100 were given compression hose
plus a placebo to lower their risk of developing a deep venous
thrombosis (DVT). These blood clots tend to occur in the lower leg
and thigh, where they can block blood flow and cause swelling and
pain. If a clot dislodges -- becoming an embolism -- it can travel
to the lungs or brain, resulting in organ damage and even
death.
After 30 days of treatment, the rate of dying was similar
between both groups of patients. Among those individuals who were
given Lovenox, the risk of death from any cause was 4.9 percent. By
contrast, this risk was 4.8 percent among those participants who
were given a placebo. The risk of major bleeds was similar between
both groups as well. The new study was supported by Sanofi, which
manufactures Lovenox.
"Does the use of Lovenox affect all-cause mortality? The answer in our study is no. We were unable to demonstrate benefit," said study author Dr. Ajay Kakkar, of the Thrombosis Research Institute and the University College London Hospitals NHS Foundation Trust, in England.
In addition to keeping these patients alive, doctors aim to
prevent "the development of blood clots and the long-term
consequences of these blood clots," Kakkar said. "You could look to
other potential benefits, but we can't say a blood thinner will
prevent death from blood clots in this group of patients."
Exactly why this agent did not help lower risk of DVT-related
death is unclear. These patients may have been too ill, and blood
clots may not be as common a cause of death as previously believed.
"There are so many other bad things that are happening that might
ultimately be the cause of their death," he said. "Preventing fatal
blood clots, although important, may be an infrequent cause of
death."
In this study, "a patient's risk of dying from a blood clot was
the same whether they had compression stockings alone or
compression stockings plus Lovenox," said Dr. Robert Myerburg, a
cardiology professor at the University of Miami School of Medicine.
"These are patients with serious medical conditions, not
post-surgical patients." The new findings do not apply to people
who take blood thinners after surgery to stave off blood clots.
Myerburg said the findings will not change how he treats his
severely ill patients and there are other reasons to prescribe
blood thinners in this group. "They may be getting other benefits
from the medication that don't translate into a lower mortality
risk, including the prevention of blood clots and their other
consequences."
More information
Visit the U.S. National Institutes of Health to learn about
deep venous thrombembolism.