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Many Dialysis Patients Get Wrong Blood Thinners for Angioplasty
Date:12/8/2009

Some docs not following FDA directive urging against use of Lovenox, Integrilin, study shows

TUESDAY, Dec. 8 (HealthDay News) -- More than one-fifth of patients on dialysis who undergo angioplasty are given blood thinners they should not be given, new research shows.

As a result, these patients are subject to a higher rate of bleeding during their hospital stay and may even be at a higher risk of dying, according to a report in the Dec. 9 issue of the Journal of the American Medical Association.

The drugs in question are enoxaparin (Lovenox), a low-molecular-weight heparin, and eptifibatide (Integrilin). The U.S. Food and Drug Administration (FDA) has determined that neither medication should be used in people undergoing dialysis.

"The study does validate the FDA's directed labeling [of these drugs] as contraindicated, and it supports avoiding use of these drugs in dialysis patients," said study author Dr. Thomas Tsai, director of interventional cardiology at the Denver VA Medical Center and an assistant professor of cardiology at the University of Colorado Denver.

"I was surprised by this," said Dr. Gregory Dehmer, a professor of internal medicine at Texas A&M Health Science Center and director of the cardiology division at Scott & White in Temple, Texas. "Clearly this indicates there's a tremendous opportunity for improvement on the part of interventional cardiologists."

According to Tsai, this particular type of medicating error may stem from the simple fact that there are so many possible medications for physicians to choose from now.

"Clearly, there's an explosion of different medications out there," he said. "I did some calculations, and found 60 combinations of medication alone that we're faced with using in the cath lab for these patients. If you take into consideration the order in which they're administered, there are over 1,000 permutations."

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