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Warfarin Sodium versus Low-Dose Heparin in the Long-Term Treatment of Venous Thrombosis
Abstract
Acute deep-vein thrombosis is usually treated with intravenous heparin for a number of days, then with oral anticoagulants for weeks to months. We have compared adjusted-dose warfarin sodium with fixed low-dose subcutaneous heparin in the prevention of recurrent deep-vein thrombosis. Sixty-eight patients with acute deep-vein thrombosis confirmed by venography were treated with intravenous heparin and then randomized to secondary prophylaxis. Nine of 35 patients receiving subcutaneous heparin, but none of 33 receiving warfarin sodium, had new episodes of objectively documented venous thromboembolism (P = 0.001). Seven patients on warfarin sodium experienced bleeding complications (of which four were major), as compared with no patients receiving subcutaneous heparin (P less than 0.005). Thus, adjusted-dose warfarin sodium is more effective than low-dose subcutaneous heparin in preventing recurrent venous thromboembolism, but its use is accompanied by a significant risk of bleeding.
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Citations
Cited by
Kearon (2012) · doi:10.1378/chest.11-2301 · Cited by 6,119
Antithrombotic Therapy for VTE Disease
Kearon, C., Akl, E. A., Ornelas, J., Blaivas, A., Jimenez, D., Bounameaux, H., Huisman, M., King, C. S., Morris, T. A., Sood, N., et al. (2016) · Chest · doi:10.1016/j.chest.2015.11.026 · Cited by 4,830
Antithrombotic Therapy for Venous Thromboembolic Disease
Büller, H. R., Agnelli, G., Hull, R. D., Hyers, T. M., Prins, M. H., & Raskob, G. E. (2004) · Chest · doi:10.1378/chest.126.3_suppl.401s · Cited by 1,249
Weitz, J. I., Hudoba, M., Massel, D., Maraganore, J., & Hirsh, J. (1990) · Journal of Clinical Investigation · doi:10.1172/jci114723 · Cited by 1,123
Self-citationSchulman, S., Rhedin, A.-S., Lindmarker, P., Carlsson, A., Lärfars, G., Nicol, P., Loogna, E., Svensson, E., Ljungberg, B., Walter, H., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199506223322501 · Cited by 932
Metadata
- Authors
- Hull, R., Delmore, T., Genton, E., Hirsh, J., Gent, M., Sackett, D., McLoughlin, D., & Armstrong, P.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1979-10-18
- Volume
- 301
- Issue
- 16
- Pages
- 855-858
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2314539657
- Cited by
- 604
- References
- 0
- FWCI
- 27.08
- Type
- journal article
- Language
- en
- Open access
- closed
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- Hull, R., Delmore, T., Genton, E., Hirsh, J., Gent, M., Sackett, D., McLoughlin, D., & Armstrong, P. (1979). Warfarin Sodium versus Low-Dose Heparin in the Long-Term Treatment of Venous Thrombosis. New England Journal of Medicine. https://doi.org/10.1056/nejm197910183011602
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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