Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized, Double-blind, Multi-center Comparison of the Efficacy and Safety of Certoparin (3000 U Anti-Xa o.d.) With Unfractionated Heparin (5000 IU t.i.d.) in the Prophylaxis of Thromboembolic Events in Acutely Ill Medical Patients
Brief Summary: This study is designed to provide efficacy and safety data for certoparin in the prophylaxis of venous thromboembolism in immobilized, acutely ill medical patients.


Options:
A: Inclusion Criteria:

1. Hospitalized medical patients 70 years of age or older
2. Acute medical illness with significant decrease in mobility expected for at least 4 days (patient bedridden or only able to walk short distances)
3. written informed consent

Exclusion Criteria:

1. immobilization longer than 3 days prior to randomization
2. prior major surgery, trauma or invasive procedure within the last 4 weeks including any injuries or operation of central nervous system
3. expected major surgical or invasive procedure within the next 3 weeks after randomization
4. LMWH/heparin administration longer than 48 hours in the 5 days prior to randomization
5. immobilization due to cast or fracture
6. indication for anticoagulatory or thrombolytic therapy
7. acute symptomatic DVT / PE
8. known hypersensitivity to any of the study drugs or drugs with similar chemical structures
9. Acute or history of heparin induced thrombocytopenia type II (HIT II)

Other protocol-defined inclusion/exclusion criteria may apply
B: List of inclusion and exclusion criteria

Inclusion Criteria:

* Hospitalization within 48 hours prior randomization for at least one of the following medical acute medical illness:

  * Acute decompensation of heart failure
  * Severe systemic infection and at least one of the following:

    * Chronic pulmonary diseases (COPD, pulmonary fibrosis, pulmonary restrictive syndrome...)
    * Obesity (BMI ≥ 30kg/m2)
    * Personal history of VTE
    * Age ≥ 60 years
  * Active cancer (defined as being histologically confirmed with an initial diagnosis or recurrence or metastasis within the past 6 months) excluding planned hospitalization for chemotherapy
* Anticipated duration of hospitalization at least 6 days
* Health status:

  * ASA Health status score ≤ 3 (American Society of Anesthesiologists)
  * ECOG ≤ 2 in cancer patient
* Anticipated life expectancy \> 1 week

Exclusion criteria:

* Major surgery or major trauma within the previous 6 weeks (orthopedic or trauma surgery to the lower extremities, gastrointestinal tract, urological, chest, gynecological surgery)
* Need for any ventilatory support (with intubation required)
* Symptomatic VTE at enrollment
* Multi organ failure
* Evidence of an active bleeding disorder
* Contraindication to anticoagulation:

  * Coagulopathy (acquired or inherited)
  * Neurosurgery within the past day 30
  * History of cerebral hemorrhage at any time
  * Known bacterial endocarditis
  * Uncontrolled arterial hypertension (systolic BP \> 200 mmHg or diastolic BP \> 110 mm Hg) at 2 successive readings
  * Haemostatic abnormalities: baseline platelet count \<50,000/mm3, activated partial thromboplastin time (aPTT) 1.5x the upper limit of normal, or International Normalized Ratio (INR) \> 1.5
  * Indication for thrombolytic therapy
  * Need for a curative treatment of anticoagulant therapy (low molecular weight heparin, unfractionated heparin, oral anticoagulant therapy)
  * Receiving LMWH or UFH at prophylactic doses for more than 72 hours prior to inclusion (patients receiving LMWH or UFH at prophylactic doses for 72 hours or less prior to entry may be included in the study)
  * Oral anticoagulant therapy within 72 hours prior to inclusion
* Cerebrovascular accident at inclusion and within 10 days prior study inclusion
* Prosthetic heart valves
* Confirmed cerebral metastases
* Known hypersensitivity to heparin or LMWH, or pork-derived products
* History of documented episode of heparin, or LMWH induced thrombocytopenia, and/or thrombosis (HIT, HAT, or HITTS)
* Participating in another clinical trial within the previous 30 days (patients with cancer included in a cancer treatment protocol are authorized to participate)
* Persistent renal failure (defined as a documented value of calculated creatinine clearance \< 30 mL/min on at least 2 occasions ³3 days prior to entry into the study)
* Known or suspected severe anemia of unexplained cause considered clinically relevant by investigator
* Spinal or epidural analgesia or lumbar puncture within the preceding 24 hours
* Unlikely to be compliant (e.g. alcohol, drug abuse)
* Women of childbearing potential not protected by effective contraceptive method of birth control and/or who are unwilling to be tested for pregnancy (pregnancy status should be checked by serum or urine pregnancy testing prior to exposure to the investigational product)
* Refusal or inability to give informed consent to participate in the study
* Inability to be followed-up after discharge until day 90 after randomization

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
C: Inclusion Criteria:

* Male and female patients aged 40 years or more
* Patients at risk of venous thromboembolic events being hospitalized for acute medical conditions as follows:

  * Heart failure, New York Heart Association (NYHA) class III or IV
  * Active cancer
  * Acute ischemic stroke
  * Acute infectious and inflammatory diseases, including acute rheumatic diseases
  * Acute respiratory insufficiency
  * Additional risk factor for VTE, including reduced mobility

Exclusion Criteria:

* Conditions that contraindicate the use of antithrombotic therapy with the Low Molecular-Weight Heparin (LMWH) enoxaparin
* Conditions that may increase the risk of bleeding, including intracranial hemorrhage
* Required drugs or procedures which may interfere with the study treatment
* Concomitant conditions or diseases which may increase the risk of study subjects or interfere with the study outcome
* General conditions in which subjects are not suitable to participate in the study
D: Inclusion Criteria:

* men and non-pregnant, non-breastfeeding women
* 40 years or older
* hospitalized with congestive heart failure or acute respiratory failure
* infection (without septic shock)
* acute rheumatic disorder
* inflammatory bowel disease

Exclusion Criteria:

* patients with venous thromboembolism (VTE)
* active bleeding or at high risk of bleeding
* unable to take oral medication
* with diseases requiring ongoing treatment with anticoagulants or antiplatelets other than aspirin at a dose ≤ 165 mg/day.

Answer: A