A multicenter randomized trial across 13 Chinese hospitals tested whether adding low-molecular-weight heparin (LMWH) to insulin improves outcomes in acute pancreatitis triggered by very high triglycerides. Among 533 adults, the composite of new-onset organ failure and/or 30-day mortality occurred in 25% of the LMWH-plus-insulin group versus 28.3% with insulin alone—a non-significant difference. Both groups achieved the triglyceride target below 500 mg/dL within a median of 2 days. Bleeding events, triglyceride rebound, and other adverse events were similar. The findings suggest that adding LMWH to insulin provides no meaningful clinical benefit and may be unnecessary in routine management of hypertriglyceridemic acute pancreatitis.
