acenocoumarol and Fractures--Bone

Topics: Acenocoumarol; Adult; Aged; Female; Fracture Fixation; Fractures, Bone; Hip Injuries; Humans; Male; Middle Aged; Postoperative Complications; Thromboembolism

The available data on the utility of low-molecular-weight heparins (LMWH) in the secondary prophylaxis of deep vein thrombosis (DVT) are limited. We compared two cohorts of patients diagnosed of DVT. One group followed treatment with LMWH and the other group did with oral anticoagulants (acenocoumarol). Safety was evaluated by the rate of major hemorrhage and 2.5-years period fracture rate, and efficacy was evaluated as the rate of early recurrence and one-year recurrence rate.. Of 65 patients treated with LMWH, the hemorrhagic rate was 1.5% (95% CI 0.08-9.40), fracture rate was 7.7% (95% CI 2.87-17.75), early recurrence was 1.5% (95% CI 0.08-9.40) and one-year recurrence was 3% (95% CI 53-11.64). In 118 patients treated with oral anticoagulants the hemorrhagic rate was 3.4% (95% CI 1.09-8.97), odds ratio 0.33, the fracture rate was 11% (95% CI 16.23-18.44), odds ratio 0.66, the early recurrence rate was 5% (95% CI 2.08-11.20), odds ratio 0.60 and one-year recurrence was 3.4% (95%CI 1.09-8.97), odds ratio 0.33.. Secondary prophylaxis of DVT with LMWH is as safe and effective as classical treatment with oral anticoagulants. In this study the 2.5-year period fracture rate was similar in both groups of treatment.

Topics: Acenocoumarol; Administration, Oral; Adult; Aged; Anticoagulants; Cohort Studies; Female; Fractures, Bone; Hemorrhage; Heparin, Low-Molecular-Weight; Humans; Incidence; Male; Middle Aged; Recurrence; Registries; Thrombophlebitis

The aim of the study was to establish whether chronic use of acenocomarol affects bone metabolism. Eighty-two males [41 treated with acenocumarol (mean therapy duration of 6.0+/-6.4 years) and 41 age-matched controls] were studied. Skeletal assessment included densitometric measurements at ultradistal forearm and calcaneus and ultrasound examination of hand phalanges and laboratory measurements included serum total calcium, phosphates, bone alkaline phosphatase (bAlp) and C-terminal telo peptide of type I collagen (ICTP). Densitometric and ultrasound variables did not differ significantly between patients and controls. Mean dose and duration of acenocumarol treatment did not affect skeletal and laboratory variables. Bone turnover was depressed, and bAlp and telopeptide were significantly lower in patients than in controls (10.0+/-7 vs. 23.0+/14 U/l, p<0.05, and 1.6+/-1.3 vs. 3.1+/-1.3 microg/l, respectively). In conclusion, despite of the lack of changes in skeletal status, male subjects on long-term acenocumarol therapy may be at high risk for fracture due to disturbances in bone turnover.

Topics: Absorptiometry, Photon; Acenocoumarol; Adult; Anticoagulants; Bone Density; Bone Remodeling; Case-Control Studies; Fractures, Bone; Humans; Male; Middle Aged; Risk Factors; Ultrasonography

Topics: Acenocoumarol; Anticoagulants; Autoradiography; Fractures, Bone; Pathology; Radiography; Rats; Research; Tibial Fractures; Toxicology; Wound Healing