Venous Thromboembolism Prophylaxis
Authors: Todd E.H. Hecht
Journal: Annals of Internal Medicine (2012)

Letters21 February 2012Venous Thromboembolism ProphylaxisTodd E.H. Hecht, MDTodd E.H. Hecht, MDFrom Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-4-201202210-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read with great interest Lederle and colleagues' systematic review (1) on venous thromboembolism (VTE) prophylaxis. The authors conclude that heparin prophylaxis resulted “in little or no net benefit.” This is in contrast to an earlier meta-analysis by Wein and colleagues (2) that used many of the same studies in medical patients and patients with stroke. I believe that Lederle and colleagues reached this conclusion erroneously.First, the authors' decision to eliminate asymptomatic deep venous thrombosis (DVT) from their analysis accounts for a substantial bias against the efficacy of VTE prophylaxis. The authors do not provide the ...References1. Lederle FA, Zylla D, MacDonald R, Wilt TJ. Venous thromboembolism prophylaxis in hospitalized medical patients and those with stroke: a background review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2011;155:602-15. [PMID: 22041949] LinkGoogle Scholar2. Wein L, Wein S, Haas SJ, Shaw J, Krum H. Pharmacological venous thromboembolism prophylaxis in hospitalized medical patients: a meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167:1476-86. [PMID: 17646601] CrossrefMedlineGoogle Scholar3. Lederle FA, Sacks JM, Fiore L, Landefeld CS, Steinberg N, Peters RW, et al. The prophylaxis of medical patients for thromboembolism pilot study. Am J Med. 2006;119:54-9. [PMID: 16431185] CrossrefMedlineGoogle Scholar4. Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet. 2000;355:1295-302. [PMID: 10776741] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Todd E.H. Hecht, MDAffiliations: From Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVenous Thromboembolism Prophylaxis in Hospitalized Medical Patients and Those With Stroke: A Background Review for an American College of Physicians Clinical Practice Guideline Frank A. Lederle , Dylan Zylla , Roderick MacDonald , and Timothy J. Wilt Venous Thromboembolism Prophylaxis Raghavendra R. Allareddy Venous Thromboembolism Prophylaxis Frank A. Lederle , Roderick MacDonald , and Timothy J. Wilt Metrics 21 February 2012Volume 156, Issue 4Page: 324KeywordsConflicts of interestDecision analysisDeep vein thrombosisHemorrhageHeparinProphylaxisPulmonary embolismStrokeSystematic reviewsVenous thromboembolism ePublished: 21 February 2012 Issue Published: 21 February 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...