Fixed-Dose Enoxaparin After Bariatric Surgery: The Influence of Body Weight on Peak Anti-Xa Levels

Introduction There is lack of data on the pharmacodynamics of low-molecular-weight heparins in obese patients. Background The aims of this study are to investigate the correlation between anti-factor Xa (anti-Xa) levels and body weight with fixed-dose enoxaparin after bariatric surgery and to invest...

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Bibliographic Details
Published in:Obesity surgery 2015-04, Vol.25 (4), p.628-634
Main Authors: Celik, Funda, Huitema, Alwin D. R., Hooijberg, Jan H., van de Laar, Arnold W. J. M., Brandjes, Dees P. M., Gerdes, Victor E. A.
Format: Article
Language:English
Subjects:
Adult
Anticoagulants - administration & dosage
Bariatric Surgery - adverse effects
Body fat
Body Weight - physiology
Correlation analysis
Dose-Response Relationship, Drug
Enoxaparin - administration & dosage
Factor Xa Inhibitors - blood
Female
Gastrointestinal surgery
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Injections, Subcutaneous
Male
Medicine
Medicine & Public Health
Middle Aged
Obesity
Obesity, Morbid - blood
Obesity, Morbid - surgery
Original Contributions
Postoperative Complications - blood
Postoperative Complications - prevention & control
Surgery
Venous Thromboembolism - prevention & control
Weight control
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Summary:Introduction There is lack of data on the pharmacodynamics of low-molecular-weight heparins in obese patients. Background The aims of this study are to investigate the correlation between anti-factor Xa (anti-Xa) levels and body weight with fixed-dose enoxaparin after bariatric surgery and to investigate the percentage of patients that reach the desired prophylactic range for anti-Xa levels. Methods Blood for anti-Xa peak levels measurement was drawn 3–5 h after administration of enoxaparin at the planned visit 8–16 days after surgery. Patients were included in three categories: 150 kg (group 3). Results Fifty-one patients were included (43.9 ± 9.9 years, 75 % women). Mean anti-Xa level was 0.37 ± 0.14 IU/ml. This level was the highest in group 1 (0.47 ± 0.13 IU/ml) and lowest in group 3 (0.23 ± 0.07). No subprophylactic (0.5 IU/ml) were most often present in group 1 (36 %). With multivariable regression analysis, body weight ( β −0.720 (95 % confidence interval −.717; −.993), p  
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-014-1435-3