Subcutaneous Heparin for Deep Venous Thrombosis
Authors: Adriano Alatri
Journal: Annals of Internal Medicine (1999)

Letters15 June 1999Subcutaneous Heparin for Deep Venous ThrombosisAdriano Alatri, MD, Paolo Bucciarelli, MD, and Marco Moia, MDAdriano Alatri, MDIRCCS Maggiore Hospital; Milan 20122, Italy (Alatri)IRCCS Maggiore Hospital; Milan 20122, Italy (Bucciarelli)IRCCS Maggiore Hospital; Milan 20122, Italy (Moia)Search for more papers by this author, Paolo Bucciarelli, MDIRCCS Maggiore Hospital; Milan 20122, Italy (Alatri)IRCCS Maggiore Hospital; Milan 20122, Italy (Bucciarelli)IRCCS Maggiore Hospital; Milan 20122, Italy (Moia)Search for more papers by this author, and Marco Moia, MDIRCCS Maggiore Hospital; Milan 20122, Italy (Alatri)IRCCS Maggiore Hospital; Milan 20122, Italy (Bucciarelli)IRCCS Maggiore Hospital; Milan 20122, Italy (Moia)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-12-199906150-00009 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Prandoni and colleagues (1) suggest that subcutaneous unfractionated heparin is an attractive approach to treating deep venous thrombosis compared with the use of low-molecular-weight-heparin (LMWH) because of the lower cost of unfractionated heparin. The main problems associated with the use of unfractionated heparin are the high variability of the anticoagulant response and the lack of an accepted method of standardization in the activated partial thromboplastin time, which is used to monitor treatment. Because unfractionated heparin treatment must be monitored (2), each hospital must establish its own therapeutic range based on a calibration curve of activated partial thromboplastin ...References1. Prandoni P, Bagatella P, Bernardi E, Girolami B, Rossi L, Scarano L, et al . Use of an algorithm for administering subcutaneous heparin in the treatment of deep venous thrombosis. Ann Intern Med. 1998;129:299-302. LinkGoogle Scholar2. Hirsh J, Raschke R, Warkentin TE, Dalen JE, Deykin D, Poller L. Heparin: mechanism of action, pharmacokinetics, dosing considerations, monitoring, efficacy and safety. Chest. 1995;108 Suppl 4 258-75. CrossrefGoogle Scholar3. Levine M, Gent M, Hirsh J, Leclerc J, Anderson D, Weits J, et al . A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med. 1996;334:677-81. CrossrefMedlineGoogle Scholar4. Koopman MM, Prandoni P, Piovella F, Ockelford PA, Brandjes DP, van der Meer J, et al . Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. N Engl J Med. 1996;334:682-87. CrossrefMedlineGoogle Scholar5. Wells PS, Kovacs MJ, Bormants J, Forgie MA, Goudie D, Morrow B, et al . Expanding eligibility for outpatient treatment of deep venous thrombosis and pulmonary embolism with low-molecular-weight heparin. Arch Intern Med. 1998;158:1809-12. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Adriano Alatri, MD; Paolo Bucciarelli, MD; Marco Moia, MDAffiliations: IRCCS Maggiore Hospital; Milan 20122, Italy (Alatri)IRCCS Maggiore Hospital; Milan 20122, Italy (Bucciarelli)IRCCS Maggiore Hospital; Milan 20122, Italy (Moia) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of an Algorithm for Administering Subcutaneous Heparin in the Treatment of Deep Venous Thrombosis Paolo Prandoni , Paola Bagatella , Enrico Bernardi , Bruno Girolami , Laura Rossi , Luigi Scarano , Antonio Marchiori , Andrea Piccioli , and Antonio Girolami Subcutaneous Heparin for Deep Venous Thrombosis Paolo Prandoni Metrics Cited byWhat to Learn from Decision Analysis of Diagnosis and Treatment of Ventilator-associated Pneumonia? 15 June 1999Volume 130, Issue 12Page: 1027KeywordsAnticoagulantsDeep vein thrombosisDrugsHematologic testsHeparinLaboratory testsLow molecular weight heparinPartial thromboplastin timePatientsResearch laboratories ePublished: 15 August 2000 Issue Published: 15 June 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...