PMID- 10669147
OWN - NLM
STAT- MEDLINE
DCOM- 20000225
LR  - 20071115
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 83
IP  - 1
DP  - 2000 Jan
TI  - Prevention of venous thromboembolism in internal medicine with unfractionated or 
      low-molecular-weight heparins: a meta-analysis of randomised clinical trials.
PG  - 14-9
AB  - BACKGROUND: The prevention of venous thromboembolic disease is less studied in 
      medical patients than in surgery. METHODS: We performed a meta-analysis of 
      randomised trials studying prophylactic unfractionated heparin (UFH) or 
      low-molecular-weight heparin (LMWH) in internal medicine, excluding acute 
      myocardial infarction or ischaemic stroke. Deep-vein thrombosis (DVT) 
      systematically detected at the end of the treatment period, clinical pulmonary 
      embolism (PE), death and major bleeding were recorded. RESULTS: Seven trials 
      comparing a prophylactic heparin treatment to a control (15,095 patients) were 
      selected. A significant decrease in DVT and in clinical PE were observed with 
      heparins as compared to control (risk reductions = 56% and 58% respectively, p 
      <0.001 in both cases), without significant difference in the incidence of major 
      bleedings or deaths. Nine trials comparing LMWH to UFH (4,669 patients) were also 
      included. No significant effect was observed on either DVT, clinical PE or 
      mortality. However LMWH reduced by 52% the risk of major haemorrhage (p = 0.049). 
      CONCLUSIONS: This meta-analysis, based on the pooling of data available for 
      several heparins, shows that heparins are beneficial in the prevention of venous 
      thromboembolism in internal medicine.
FAU - Mismetti, P
AU  - Mismetti P
AD  - Clinical Pharmacology Unit, University Hospital of Saint-Etienne, France. 
      mismetti@univ-st-etienne.fr
FAU - Laporte-Simitsidis, S
AU  - Laporte-Simitsidis S
FAU - Tardy, B
AU  - Tardy B
FAU - Cucherat, M
AU  - Cucherat M
FAU - Buchmuller, A
AU  - Buchmuller A
FAU - Juillard-Delsart, D
AU  - Juillard-Delsart D
FAU - Decousus, H
AU  - Decousus H
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*administration & dosage
MH  - Heparin/*administration & dosage
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
MH  - Venous Thrombosis/*prevention & control
EDAT- 2000/02/11 09:00
MHDA- 2000/03/04 09:00
CRDT- 2000/02/11 09:00
PHST- 2000/02/11 09:00 [pubmed]
PHST- 2000/03/04 09:00 [medline]
PHST- 2000/02/11 09:00 [entrez]
AID - 00010014 [pii]
PST - ppublish
SO  - Thromb Haemost. 2000 Jan;83(1):14-9.