Goudable et al 11 investigated the pharmacokinetics of nadroparin calcium after a single bolus intravenous injection The clearance of anti-Xa activity and the CrCl were not correlated. Body mass index was calculated as self-reported weight in kilograms divided by the square of the height in meters. We are indebted to the participants in the Physicians’ Health Study for their outstanding commitment and cooperation; to the entire Physicians’ Health Study staff for their expert and unfailing assistance; and to Patrick J. Arch Pathol Lab Med. In this prospective cohort, increasing BMI was associated with a steady increase in the risks of total, ischemic, and hemorrhagic stroke.

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Baseline information was self-reported and collected by a mailed questionnaire that asked about many demographic, medical history, and lifestyle variables. The age- and multiple-adjusted relative risks of total, ischemic, and hemorrhagic stroke according to BMI categories are summarized in Table 2. In the Honolulu Heart Program, nonsmoking men in the highest tertile of BMI at age 25 years had a 2-fold increased risk of ischemic stroke over 22 years of follow-up.

Body mass index was not associated with the severity of total and ischemic stroke, but the data suggest that it might be inversely associated with severity of fatal hemorrhagic stroke, particularly subarachnoid hemorrhage. Participants who self-reported stroke on a follow-up questionnaire were asked for permission to obtain their medical records.

Purchase access Subscribe to JN Learning for one year. Data from review articles and animal studies were not considered.

In contrast, accumulation was not observed in a trial with the higher-molecular-weight agent tinzaparin. The search identified citations that were screened for eligibility, most of which were excluded on the basis of the publication type letter, review, or editorial or study population animal studies or patients receiving hemodialysis or hemofiltration.


The names of all authors of relevant articles were then used to search the cited reference field of the Science Citation Index Institute for Scientific Information, from to May 17, Baseline characteristics were not provided internationsl the control group.

Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Stroke severity for total and ischemic stroke was not associated with BMI.

An informal review of the literature identified 2 approaches to the treatment of patients with renal impairment who require parenteral anticoagulation.

Sign in to make a comment Sign in to your personal account. Sign in to access your subscriptions Sign in to intenational personal account. We considered hypertension, diabetes, and high cholesterol levels as possible biological mediators of the effect of BMI on stroke and therefore did not control for these factors in the primary analysis. However, it is not clear whether any particular cutoff in CrCl is a threshold below which there is a danger of accumulation of the anticoagulant effect of LMW heparin.

It is not possible to determine a cutoff point at which the risk of anti-Xa heparin activity accumulation increases from this study because of the narrow range of CrCls studied.

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The authors did not specify the method used to determine CrCl. Data from trials using nadroparin, enoxaparin, and Cy confirm the view that accumulation internaional anti-Xa heparin activity is possible in patients with renal impairment. Arterioscler Thromb Vasc Biol. Some of these had small sample sizes 910 and others did not classify stroke subtypes.


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The mechanism by which BMI affects stroke risk ibternational of established risk factors such as hypertension and diabetes internatinal not fully understood. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease.

Sign in to customize your 12.22 Sign in to your personal account. We evaluated effect modification of BMI by smoking, hypertension, alcohol consumption, and age. We used an ordinal variable to test for trend in risk across BMI categories. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. All studies included for review used chromogenic anti-Xa assays for determining plasma LMW heparin levels, which is the recommended method of the College of American Pathologists.

This suggests that the type of renal injury should be considered in future investigations. We therefore attempted to develop operational guidelines for the use of LMW heparin in patients with renal insufficiency.

The reports were screened and retrieved by one of us J. Among the hemorrhagic stroke cases, First, age-related reductions in glomerular filtration rate may not lead to the same degree of accumulation of anti-Xa activity as acute glomerular internatiknal does.

However, the age-adjusted percentage of fatal intraparenchymal hemorrhages among obese men 8.

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