Anticoagulant Prophylaxis for Hospitalized Medical Patients
Authors: Frank A. Lederle, Roderick MacDonald, Timothy J. Wilt
Journal: Annals of Internal Medicine (2007)

Letters2 October 2007Anticoagulant Prophylaxis for Hospitalized Medical PatientsFrank A. Lederle, MD, Roderick MacDonald, MS, and Timothy J. Wilt, MD, MPHFrank A. Lederle, MDFrom the Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minneapolis, MN 55417.Search for more papers by this author, Roderick MacDonald, MSFrom the Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minneapolis, MN 55417.Search for more papers by this author, and Timothy J. Wilt, MD, MPHFrom the Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minneapolis, MN 55417.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-7-200710020-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their article on anticoagulant prophylaxis to prevent symptomatic venous thromboembolism (VTE) in hospitalized medical patients, Dentali and colleagues (1) base their conclusion that anticoagulant prophylaxis is effective on 2 overlapping significant findings, namely reductions in any pulmonary embolisms (PEs) and fatal PEs. These 2 differences were largely driven by the results of 3 studies: Cohen and colleagues' study (2), Gårdlund's study (3), and Mahé and colleagues' study (4). The devil is in the details, and closer examination of these data calls Dentali and colleagues' conclusion into question.First, Cohen and coworkers report no PEs in the ...References1. Dentali F, Douketis JD, Gianni M, Lim W, Crowther MA. Meta-analysis: anticoagulant prophylaxis to prevent symptomatic venous thromboembolism in hospitalized medical patients. Ann Intern Med. 2007;146:278-88. [PMID: 17310052] LinkGoogle Scholar2. Cohen AT, Davidson BL, Gallus AS, Lassen MR, Prins MH, Tomkowski W, et al. Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ. 2006;332:325-9. [PMID: 16439370] CrossrefMedlineGoogle Scholar3. Gärdlund B. Randomised, controlled trial of low-dose heparin for prevention of fatal pulmonary embolism in patients with infectious diseases. The Heparin Prophylaxis Study Group. Lancet. 1996;347:1357-61. [PMID: 8637340] CrossrefMedlineGoogle Scholar4. Mahé I, Bergmann JF, d'Azémar P, Vaissie JJ, Caulin C. Lack of effect of a low-molecular-weight heparin (nadroparin) on mortality in bedridden medical in-patients: a prospective randomised double-blind study. Eur J Clin Pharmacol. 2005;61:347-51. [PMID: 15981008] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Frank A. Lederle, MD; Roderick MacDonald, MS; Timothy J. Wilt, MD, MPHAffiliations: From the Minneapolis Veterans Affairs Center for Chronic Disease Outcomes Research, Minneapolis, MN 55417. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Anticoagulant Prophylaxis to Prevent Symptomatic Venous Thromboembolism in Hospitalized Medical Patients Francesco Dentali , James D. Douketis , Monica Gianni , Wendy Lim , and Mark A. Crowther Anticoagulant Prophylaxis for Hospitalized Medical Patients Mark A. Crowther , Francesco Dentali , Wendy Lim , and James D. Douketis Metrics Cited byPeripheral Arterial Disease Assessment and Management 2 October 2007Volume 147, Issue 7Page: 523-524KeywordsAnticoagulantsAutopsyConflicts of interestHeparinProphylaxisPulmonary embolismVenous thromboembolism ePublished: 2 October 2007 Issue Published: 2 October 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...