January 1, 2005Thrombosis JournalOpen Access

Rates of clinically apparent heparin-induced thrombocytopenia for unfractionated heparin vs. low molecular weight heparin in non-surgical patients are low and similar.

Q: What is the clinical evidence from this study?

Study design: Review. Population: Venous thromboembolism (VTE) treatment or prevention. Intervention: Unfractionated heparin (UFH) vs. Low molecular weight heparin (LMWH). Primary outcome: Heparin-induced thrombocytopenia (HIT) or thrombocytopenia.

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Key result

The risk of thrombocytopenia and heparin-induced thrombocytopenia is low and similar for non-surgical patients receiving either low-molecular-weight heparin or unfractionated heparin.

Why the study?

Does LMWH reduce the risk of heparin-induced thrombocytopenia compared to UFH in non-surgical patients?

Structured PICO

Does LMWH reduce the risk of heparin-induced thrombocytopenia compared to UFH in non-surgical patients?

Population

Non-surgical medical patients receiving unfractionated heparin or low-molecular-weight heparin for the treatment or prevention of venous thromboembolism.

Intervention

Low molecular weight heparin (LMWH)

Comparator

Unfractionated heparin (UFH)

Outcome

Rates of clinically apparent heparin-induced thrombocytopenia (HIT) or thrombocytopeniasafety

The risk of heparin-induced thrombocytopenia appears low and similar between unfractionated and low molecular weight heparins in non-surgical patients, suggesting that the higher risk seen with UFH in orthopedic patients may not apply to medical patients.

Limitations

Lack of uniform evaluation and standardized testing for HIT in the current literature
Heterogeneity in the endpoints used among the reviewed trials
Length of treatment in the reviewed studies may be too short for patients to develop clinically-evident HIT
Length of treatment in the reviewed studies (7-10 days) may be too short for patients to develop clinically-evident HIT

Discussion

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Implication

Does not support preferring LMWH over UFH to lower HIT risk in non-surgical patients; leaves open confirmation in prospective trials.

Cite This Study

Locke et al. (2005) conducted a review in Venous thromboembolism (VTE) treatment or prevention. Unfractionated heparin (UFH) vs. Low molecular weight heparin (LMWH) was evaluated on Heparin-induced thrombocytopenia (HIT) or thrombocytopenia. The risk of thrombocytopenia and heparin-induced thrombocytopenia is low and similar for non-surgical patients receiving either low-molecular-weight heparin or unfractionated heparin.

synapsesocial.com/papers/6a92a26a78b6d4c32c4f337d https://doi.org/10.1186/1477-9560-3-4

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Rates of clinically apparent heparin-induced thrombocytopenia for unfractionated heparin vs. low molecular weight heparin in non-surgical patients are low and similar.

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Rates of clinically apparent heparin-induced thrombocytopenia for unfractionated heparin vs. low molecular weight heparin in non-surgical patients are low and similar.

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider