TY - JOUR
T1 - Heparin for 5 days as compared with 10 days in the initial treatment of proximal venous thrombosis
AU - Hull, Russell D.
AU - Raskob, Gary E.
AU - Rosenbloom, David
AU - Panju, Akbar A.
AU - Brill-Edwards, Patrick
AU - Ginsberg, Jeffrey S.
AU - Hirsh, Jack
AU - Martin, Gary J.
AU - Green, David
PY - 1990/5/3
Y1 - 1990/5/3
N2 - It is common practice to begin anticoagulant treatment of deep-vein thrombosis with a 10-day course of intravenous heparin, with warfarin added on day 5 to 10 and continued for several months. We performed a randomized, double-blind trial comparing a shorter course of continuous intravenous heparin (5 days, with warfarin sodium begun on the first day) with the conventional 10-day course of heparin (with warfarin sodium begun on the fifth day) in the initial treatment of 199 patients with acute proximal venous thrombosis documented by venography. The frequency of objectively documented recurrent venous thromboembolism was low and essentially the same in the two groups (7.1 percent in the short-course group vs. 7.0 percent in the long-course group). Because the observed difference between the groups was 0.1 percent in favor of the long-course group, it is unlikely (P<0.05) that a true difference in favor of this group would be greater than 7.5 percent; the difference could be as much as 7.3 percent in favor of the short-course group. Major bleeding episodes were infrequent, and the rate was similar in both groups. We conclude that a five-day course of heparin is as effective as a 10-day course in treating deep venous thrombosis. Furthermore, using the shorter course would permit earlier discharge from the hospital and thus offer substantial cost savings. (N Engl J Med 1990; 322:1260–4.)
AB - It is common practice to begin anticoagulant treatment of deep-vein thrombosis with a 10-day course of intravenous heparin, with warfarin added on day 5 to 10 and continued for several months. We performed a randomized, double-blind trial comparing a shorter course of continuous intravenous heparin (5 days, with warfarin sodium begun on the first day) with the conventional 10-day course of heparin (with warfarin sodium begun on the fifth day) in the initial treatment of 199 patients with acute proximal venous thrombosis documented by venography. The frequency of objectively documented recurrent venous thromboembolism was low and essentially the same in the two groups (7.1 percent in the short-course group vs. 7.0 percent in the long-course group). Because the observed difference between the groups was 0.1 percent in favor of the long-course group, it is unlikely (P<0.05) that a true difference in favor of this group would be greater than 7.5 percent; the difference could be as much as 7.3 percent in favor of the short-course group. Major bleeding episodes were infrequent, and the rate was similar in both groups. We conclude that a five-day course of heparin is as effective as a 10-day course in treating deep venous thrombosis. Furthermore, using the shorter course would permit earlier discharge from the hospital and thus offer substantial cost savings. (N Engl J Med 1990; 322:1260–4.)
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U2 - 10.1056/NEJM199005033221802
DO - 10.1056/NEJM199005033221802
M3 - Article
C2 - 2183055
AN - SCOPUS:0025326059
SN - 0028-4793
VL - 322
SP - 1260
EP - 1264
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 18
ER -