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Do the low molecular weight heparins improve efficacy and safety of the treatment of deep venous thrombosis? A meta-analysis
Authors: Rocha, E. (Eduardo)
Martinez-Gonzalez, M.A. (Miguel Ángel)
Montes, R. (Ramón)
Panizo, C. (Carlos)
Keywords: Hemorrhage/chemically induced
Heparin/standards/therapeutic use/toxicity
Heparin, Low-Molecular-Weight/standards/therapeutic use/toxicity
Issue Date: 2000
Publisher: Ferrata Storti Foundation
Publisher version:
ISSN: 0390-6078
Citation: Rocha E, Martinez-Gonzalez MA, Montes R, Panizo C. Do the low molecular weight heparins improve efficacy and safety of the treatment of deep venous thrombosis? A meta-analysis. Haematologica 2000 Sep;85(9):935-942.
We compared the efficacy and safety of low molecular weight heparins (LMWH) and unfractionated heparin (UFH) in the treatement of deep venous thrombosis (DVT). A comparison between two daily subcutaneous injections of LMWH against a single injection was also performed. DESIGN AND METHODS: The study was performed by a meta-analysis. Clot improvement in venography, recurrency, total mortality and major hemorrhages were assessed in 4,472 patients with DVT from 21 studies treated with subcutaneous LMWH or UFH. RESULTS: An improvement in clot reduction (odds ratio 0.73, 95% confidence interval 0.59 to 0.90, p = 0.004), a decrease in total mortality (0. 68, 0.50 to 0.91, p = 0.012) and a lower incidence of hemorrhage (0. 65, 0.43 to 0.98, p = 0.047) were observed in LMWH treated patients. There were no differences in recurrences (0.78, 0.59 to 1.04, p = 0. 10). A single dose of LMWH was better than two in reducing major bleeding (c2 = 4.99, p = 0.025); however, the two dose regimen was more effective in clot reduction (c2 = 8.56, p = 0.004). INTERPRETATION AND CONCLUSIONS: LMWH is superior to UFH in terms of safety and efficacy. A single daily dose of LMWH dose is a suitable therapeutic regimen and could facilitate the outpatient treatment of venous thromboembolism.
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DA - CUN - Hematología y Hemoterapia - Artículos de revista

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