Why the study?
Does heparin effectively treat venous thromboembolism in patients with congenital deficiency of antithrombin III?
Does heparin effectively treat venous thromboembolism in patients with congenital deficiency of antithrombin III?
Heparin resistance is not a major problem in most patients with congenital AT III deficiency and acute VTE, suggesting routine AT III concentrate substitution is not cost-effective.
May support avoiding routine AT III substitution in heparin-treated VTE; leaves open need for randomized confirmation.
The treatment course of all thromboembolic events in the patients with congenital deficiency of antithrombin III (AT III) in the national Swedish register was reviewed in order to assess the appropriate medical therapy in this situation. The medical treatment of 70 events of venous thromboembolism was evaluated. There were eight cases with signs of clinical progression. The risk of therapeutic failure with heparin could be as low as 1.5% or as high as 9.2%. It would not be cost-effective to substitute with concentrates of AT III in every case with congenital deficiency thereof in connection with acute venous thromboembolism. "Heparin resistance" does not seem to be a problem in the vast majority of these patients.
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Schulman et al. (1992) studied this question.
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