A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis

New England Journal of Medicine

Volumn 334, Issue 11, 1996, Pages 677-681

  Levine, Mark ^a,b,c   Gent, Michael ^a,b   Hirsh, Jack ^a,b   Leclerc, Jacques ^d   Anderson, David ^e   Weitz, Jeffrey ^a   Ginsberg, Jeffrey ^a   Turpie, Alexander G ^a   Demers, Christine ^f   Kovacs, Michael ^g   Geerts, William ^h   Kassis, Jeanine ⁱ   Desjardins, Louis ^f   Cusson, Jean ⁱ   Cruickshank, Moira ^g   Powers, Peter ^a   Brien, William ^g   Haley, Susan ^b   Willan, Andrew ^a,b  

^a MCMASTER UNIVERSITY   (Canada)

^b HAMILTON HEALTH SCIENCES   (Canada)

^c JURAVINSKI CANCER CENTRE   (Canada)

^d MCGILL UNIVERSITY   (Canada)

^e DALHOUSIE UNIVERSITY   (Canada)

^f UNIVERSITÉ LAVAL   (Canada)

^g UNIVERSITY OF WESTERN ONTARIO   (Canada)

^h UNIVERSITY OF TORONTO   (Canada)

ⁱ UNIVERSITÉ DE MONTRÉAL   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ANTICOAGULANT AGENT; ENOXAPARIN; HEPARIN; LOW MOLECULAR WEIGHT HEPARIN; WARFARIN;

ACUTE DISEASE; ADULT; ANTICOAGULANT THERAPY; ARTICLE; BLEEDING; CLINICAL TRIAL; DEEP VEIN THROMBOSIS; DRUG EFFICACY; DRUG SAFETY; FEMALE; HUMAN; INTRAVENOUS DRUG ADMINISTRATION; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; META ANALYSIS; PRIORITY JOURNAL; RECURRENT DISEASE; SUBCUTANEOUS DRUG ADMINISTRATION; THROMBOEMBOLISM; TREATMENT OUTCOME;

AGED; ANTICOAGULANTS; ENOXAPARIN; FEMALE; HEMORRHAGE; HEPARIN; HOME NURSING; HOSPITALIZATION; HUMANS; INFUSIONS, INTRAVENOUS; INJECTIONS, SUBCUTANEOUS; MALE; MIDDLE AGED; POPLITEAL VEIN; RECURRENCE; SELF ADMINISTRATION; THROMBOEMBOLISM; THROMBOSIS; TREATMENT OUTCOME;

EID: 0006590545     PISSN: 00284793     EISSN: None     Source Type: Journal    
DOI: 10.1056/NEJM199603143341101     Document Type: Article

References (22)

1. Hirsh J, Heparin. N Engl J Med 1991;324:1565-74.
2. Hirsh J, van Aken WO, Gallus AS, Dollery CT, Cade JF, Yung WL. Heparin kinetics in venous thrombosis and pulmonary embolism. Circulation 1976;53:691-5
3. Hirsh J, Levine MN Low molecular weight heparin Blood 1992;79:1-17
4. Prandoni P. Lensing AW, Buller HR, et al. Comparison of subcutaneous low-molecular-weight heparin with intravenous standard heparin in proximal deep-vein thrombosis. Lancet 1992,339:441-5.
5. Hull RD, Raskob GE, Pineo GF, et al. Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis. N Engl J Med 1992;326 975-82.
6. Simonneau G, Charbonnier B, Decousus H, et al. Subcutaneous low-molecular-weight heparin compared with continuous intravenous unfractionated heparin in the treatment of proximal deep vein thrombosis. Arch Intern Med 1993;153:1541-6.
7. Boneu B, Caranobe C, Cadroy Y, et al. Pharmacokinetic studies of standard unfractionated heparin and low molecular weight heparins in the rabbit. Semin Thromb Hemost 1988;14.8-27.
8. Bara L, Billaud E, Gramond G, Kher A, Samama M Comparative pharmacokinetics of a low molecular weight heparin (PK 10 169) and unfractionated heparin after intravenous and subcutaneous administration. Thromb Res 1985;39:631-6.
9. Young E, Prins M, Levine MN, Hirsh J. Heparin binding to plasma proteins, an important mechanism for heparin resistance Thromb Haemost 1992,67 639-43.
10. Cruickshank MK, Levine MN, Hirsh J, Roberts R, Siguenza M. A standard heparin nomogram for the management of heparin therapy. Arch Intern Med 1991;151:333-7.
11. Hull RD, Carter CJ, Jay RM, et al. The diagnosis of acute, recurrent, deepvein thrombosis: a diagnostic challenge. Circulation 1983;67:901-6.
12. Lensing AWA, Prandom P, Brandjes D, et al. Detection of deep-vein thrombosis by real-time B-mode ultrasonography N Engl J Med 1989;320:342-5.
13. Hull RD, Hirsh J, Carter CJ, et al Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 1983;98:891-9.
14. Levine MN, Hirsh J, Landefeld S, Raskob G Hemorrhagic complications of anticoagulant treatment Chest 1992;102:Suppl 4:352S-363S.
15. Thomas DG, Gart JJ. A table of exact confidence limits for differences and ratios of two proportions and their odds ratios J Am Stat Assoc 1977,72:73-6.
16. Lensing AW, Prins MH, Davidson BL, Hirsh J. Treatment of deep venous thrombosis with low-molecular-weight heparins: a meta-analysis. Arch Intern Med 1995;155.601-7.
17. Lagerstedt CI, Olsson CG, Fagher BO, Oqvist BW, Albrechtsson U. Need for long-term anticoagulant treatment in symptomatic calf-vein thrombosis. Lancet 1985;2:515-8
18. Brandjes DPM, Heijboer H, Buller HR, de Rijk M, Jagt H, ten Cate JW. Acenocoumarol and heparin compared with acenocoumarol alone in the initial treatment of proximal-vein thrombosis. N Engl J Med 1992,327:1485-9.
19. Holm HA, Ly B, Handeland GF, et al. Subcutaneous heparin treatment of deep venous thrombosis: a comparison of unfractionated and low molecular weight heparin. Haemostasis 1986;16:Suppl 2 30-7.
20. Bratt G, Aberg W, Johansson M, Tornebohm E, Granqvist S, Lockner D. Two daily subcutaneous injections of fragmin as compared with intravenous standard heparin in the treatment of deep venous thrombosis. Thromb Haemost 1990;64.506-10
21. Pini M, Aiello S, Manotti C, et al. Low molecular weight heparin versus warfarin in the prevention of recurrences after deep vein thrombosis. Thromb Haemost 1994;72:191-7.
22. Monreal M, Lafoz E, Olive A, del Rio L, Vedia C. Comparison of subcutaneous unfractionated heparin with a low molecular weight heparin (Fragmin) in patients with venous thromboembolism and contraindications to coumarin Thromb Haemost 1994;71:7-11.