Prevention and treatment of venous thromboembolism in the elderly patient

Figures & data

Table 1 The main features and results of the three most important randomized trials on pharmacological prophylaxis in medical patients

	MEDENOX	PREVENT	ARTEMIS
Eligibility criteria
Age	≥40	≥40	≥60
Bed rest	≥6 days	≥4 days	≥4 days
Disease	Acute heart failure; Acute respiratory illness; or Infection; Bone/joint, Inflamed bowel plus	Acute heart failure; Acute respiratory illness; or Infection; Bone/joint, Inflamed bowel plus	Acute heart failure; acute or chronic lung disease, acute infectious or inflammatory disease
VTE risk	≥1 (>75 y, cancer, previous VTE, obesity, varicose veins, hormones, chronic heart or lung failure)	≥1 (>75 y, cancer, previous VTE, obesity, varicose veins, hormones, chronic heart or lung failure)
Treatments
	Enoxaparin 40 mg	Dalteparin 5000 UI	Fondaparinux 2.5 mg
	Enoxaparin 20 mg	Placebo	Placebo
	Placebo
End points
At Day	14 Venographic distal or proximal DVT	21 Proximal ultrasonographic DVT	15 Venographic distal or proximal DVT
plus	Symptomatic VTE	Symptomatic VTE	Symptomatic VTE
plus	Fatal PE	Fatal PE and sudden death	Fatal PE
Safety	Major bleeding Death at day 90	Major bleeding Death at day 90	Major bleeding Death at day 90
Results
	Enoxaparin 40 mg 5.5%	Dalteparin 2.7%	Fondaparinux 5.6%
	Placebo 14.9%	Placebo 4.96%	Placebo 10.5 %
	p = 0.001	p = 0.0015	p = 0.029

Abbreviations: DVT, deep vein thrombosis; PE, pulmonary embolism; VTE, venous thromboembolism.