What question did this study set out to answer?

This study aims to compare the effectiveness and safety of subcutaneous low-molecular-weight heparin versus continuous intravenous heparin in treating proximal vein thrombosis.

March 1, 1995Clinical and Applied Thrombosis/Hemostasis

The Treatment of Proximal Vein Thrombosis with Subcutaneous Low-Mole Molecular-Weight Heparin Compared with Continuous Intravenous Heparin

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Why the study?

Does fixed-dose subcutaneous low-molecular-weight heparin reduce new episodes of venous thromboembolism compared to adjusted-dose intravenous heparin in patients with proximal vein thrombosis?

Population

432 patients with proximal vein thrombosis

Comparison

Fixed-dose, subcutaneous low-molecular-weight… vs Adjusted-dose intravenous heparin given by…

Design

RCT, double-blind

Authors

RHRussell D. HullVascular Medicine GRGary E. RaskobNorthwestern University GPGraham F. PineoVascular / Pulmonary Vascular

Discussion

Member takes

Implication

Supports LMWH as at least as effective as IV heparin for proximal DVT; extends options for convenient outpatient regimens in practice and trials.

Key Points

This study aims to compare the effectiveness and safety of subcutaneous low-molecular-weight heparin versus continuous intravenous heparin in treating proximal vein thrombosis.
Multicenter double-blind clinical trial with 432 patients
Fixed-dose subcutaneous low-molecular-weight heparin versus adjusted-dose intravenous heparin
Clinical outcomes documented objectively
2.8% of patients on low-molecular-weight heparin developed new venous thromboembolism compared to 6.9% on intravenous heparin (p = 0.07)
Major bleeding occurred in 0.5% of low-molecular-weight heparin group versus 5.0% in the intravenous group, with a 91% risk reduction (p = 0.006)
Death rates were 4.7% for low-molecular-weight heparin versus 9.6% for intravenous heparin, a 51% risk reduction (p = 0.049)

Structured PICO

Does fixed-dose subcutaneous low-molecular-weight heparin reduce new episodes of venous thromboembolism compared to adjusted-dose intravenous heparin in patients with proximal vein thrombosis?

Population

432 patients with proximal vein thrombosis

Intervention

Fixed-dose, subcutaneous low-molecular-weight heparin given once daily

Comparator

Adjusted-dose intravenous heparin given by continuous infusion

Outcome

New episodes of venous thromboembolismhard clinical

Once-daily subcutaneous low-molecular-weight heparin is at least as effective as continuous intravenous heparin for proximal deep vein thrombosis, with significant reductions in initial major bleeding and overall mortality.

Cite This Study

Hull et al. (1995) studied this question.

synapsesocial.com/papers/6a7379843800ec2ea6a72ad3 https://doi.org/10.1177/107602969500100208

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Implication

Supports LMWH as at least as effective as IV heparin for proximal DVT; extends options for convenient outpatient regimens in practice and trials.

The Treatment of Proximal Vein Thrombosis with Subcutaneous Low-Mole Molecular-Weight Heparin Compared with Continuous Intravenous Heparin

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The Treatment of Proximal Vein Thrombosis with Subcutaneous Low-Mole Molecular-Weight Heparin Compared with Continuous Intravenous Heparin

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider