PMID- 8629671
OWN - NLM
STAT- MEDLINE
DCOM- 19960627
LR  - 20220318
IS  - 0002-9343 (Print)
IS  - 0002-9343 (Linking)
VI  - 100
IP  - 3
DP  - 1996 Mar
TI  - Low-molecular-weight heparins and unfractionated heparin in the treatment of 
      patients with acute venous thromboembolism: results of a meta-analysis.
PG  - 269-77
AB  - PURPOSE: To obtain reliable estimates of the relative efficacy and safety of 
      low-molecular-weight heparins (LMWHs) and unfractionated heparin (UFH) in the 
      treatment of patients with venous thromboembolism. METHODS: A literature search 
      of randomized trials evaluating LMWH and UFH for the period from 1980 to 1994 was 
      conducted to obtain data for a meta-analysis. Studies were classified as level 1 
      if they were double-blind or if there was blinded assessment of outcome measures, 
      and level 2 if they did not provide assurance of blinded outcome assessment. 
      RESULTS: In level 1 studies, the relative risk (RR) of recurrent venous 
      thromboembolism during the first 15 days and over the entire period of 
      anticoagulant therapy was 0.24 (95% confidence intervals [CI] 0.06 to 0.80, P = 
      0.02) and 0.39 (95% CI 0.30 to 0.80, P = 0.006), respectively, in favor of LMWH 
      treatment. The RR for major bleeding was 0.42 (95% CI 0.2 to 0.9, P = 0.01), in 
      favor of LMWH. In level 2 studies, no significant differences in the rates of 
      recurrent venous thromboembolism or major bleeding were observed. Pooling level 1 
      and level 2 studies, the RR for overall mortality and mortality in cancer 
      patients was 0.51 (95% CI 0.2 to 0.9, P = 0.01), and 0.33 (95% CI 0.1 to 0.8, P = 
      0.01), respectively in favor of LMWH. CONCLUSIONS: LMWH are likely to be more 
      effective than UFH in preventing recurrent venous thromboembolism, to produce 
      less major bleeding, and to be associated with a lower mortality rate, 
      particularly in the subgroup of patients with cancer.
FAU - Siragusa, S
AU  - Siragusa S
AD  - Department of Internal Medicine, IRCCS Policlinico S. Matteo, Pavia, Italy.
FAU - Cosmi, B
AU  - Cosmi B
FAU - Piovella, F
AU  - Piovella F
FAU - Hirsh, J
AU  - Hirsh J
FAU - Ginsberg, J S
AU  - Ginsberg JS
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
CIN - ACP J Club. 1996 Sep-Oct;125(2):30
MH  - Acute Disease
MH  - Heparin/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Recurrence
MH  - Research Design
MH  - Survival Analysis
MH  - Thromboembolism/*drug therapy/mortality
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 1996/03/01 00:00
MHDA- 1996/03/01 00:01
CRDT- 1996/03/01 00:00
PHST- 1996/03/01 00:00 [pubmed]
PHST- 1996/03/01 00:01 [medline]
PHST- 1996/03/01 00:00 [entrez]
AID - S0002-9343(97)89484-3 [pii]
AID - 10.1016/S0002-9343(97)89484-3 [doi]
PST - ppublish
SO  - Am J Med. 1996 Mar;100(3):269-77. doi: 10.1016/S0002-9343(97)89484-3.