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Dalteparin improved chronic foot ulcers and reduced the number of amputations in diabetic peripheral arterial occlusive disease

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 Q In diabetic patients with peripheral arterial occlusive disease (PAOD), is dalteparin more effective than placebo for improving chronic foot ulcers?

Clinical impact ratings Endocrine ★★★★★★☆

METHODS

Embedded ImageDesign:

randomised placebo controlled trial.

Embedded ImageAllocation:

concealed.*

Embedded ImageBlinding:

blinded (patients and healthcare providers).*

Embedded ImageFollow up period:

6 months.

Embedded ImageSetting:

4 hospitals in Sweden.

Embedded ImagePatients:

87 diabetic patients (mean age 72.5 y, 71% men) with PAOD, chronic foot ulcers (Wagner classification ulcer stage I and II) with duration >2 months; toe blood pressure (TBP) to arm blood pressure index ⩽0.6; and a daily dose of aspirin, 75 mg, for ⩾4 weeks. Exclusion criteria included vascular reconstruction or angioplasty in previous 3 months, renal insufficiency (serum creatinine ⩾200 µmol/l), and anticoagulants. All patients continued to receive aspirin.

Embedded ImageIntervention

patients were stratified …

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Footnotes

  • * See glossary.

  • For correspondence: Dr M Kalani, Karolinska Hospital, Stockholm, Sweden. majid.kalaniks.se

  • Sources of funding: Pharmacia Corporation; Swedish Heart-Lung Foundation; Stockholm County Council; R&D Department of the Public Health and Medical Services Committee.

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