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Review: low molecular weight heparin reduces recurrent venous thromboembolism better than unfractionated heparin

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 Q In patients with acute venous thromboembolism (VTE), is fixed dose subcutaneous low molecular weight heparin (LMWH) more effective than adjusted dose unfractionated heparin (UFH) for reducing symptomatic recurrent VTE?

Clinical impact ratings IM/Ambulatory care ★★★★★☆☆ Internal medicine ★★★★★☆☆ Haematology ★★★★☆☆☆


Embedded ImageData sources:

Cochrane Peripheral Vascular Diseases Specialized Register (July 2004), the Cochrane Central Register of Controlled Trials (Issue 3, 2004), LILACS, bibliographies of relevant articles, researchers, and pharmaceutical companies.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared fixed dose subcutaneous LMWH with adjusted dose UFH (intravenous or subcutaneous) for initial treatment (usually the first 5–14 d) in patients with acute VTE. After selection, each study was assessed for adequacy of concealment of allocation before randomisation.

Embedded ImageOutcomes:

recurrent symptomatic VTE, major haemorrhage, and all cause mortality.


22 RCTs (n = 8867) met the selection criteria. Categories of VTE included symptomatic deep venous …

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  • For correspondence: Professor M Prins, University of Maastricht, Maastricht, The Netherlands.

  • Source of funding: Scottish Executive UK.