Low-Molecular-Weight Heparin and Bleeding: How Do We Lower Risk but Maintain Benefit?

Letter

Low-Molecular-Weight Heparin and Bleeding: How Do We Lower Risk but Maintain Benefit?

T. S. Dharmarajan, MD; and
Amit Sohagia, MD

From Our Lady of Mercy Medical Center, Bronx, New York.

TO THE EDITOR:

We read with interest the important information in the recent meta-analysis by Lim and colleagues (1). The meta-analysis suggested that patients with severe renal insufficiency who are receiving standard doses of enoxaparin have an increased risk for major bleeding that may be attributable to an elevated level of anti-Xa. The presence of renal impairment causes a delay in the elimination of enoxaparin. In …

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