The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Treatment of Venous Thrombosis with Intravenous Unfractionated Heparin Administered in the Hospital as Compared with Subcutaneous Low-Molecular-Weight Heparin Administered at Home
Open accessAbstract
BACKGROUND: An intravenous course of standard (unfractionated) heparin with the dose adjusted to prolong the activated partial-thromboplastin time to a desired length is the standard initial in-hospital treatment for patients with deep-vein thrombosis, but fixed-dose subcutaneous low-molecular-weight heparin appears to be as effective and safe. Because the latter treatment can be given on an outpatient basis, we compared the two treatments in symptomatic outpatients with proximal-vein thrombosis but no signs of pulmonary embolism. METHODS: We randomly assigned patients to adjusted-dose intravenous standard heparin administered in the hospital (198 patients) or fixed-dose subcutaneous low-molecular-weight heparin administered at home, when feasible (202 patients). We compared the treatments with respect to recurrent venous thromboembolism, major bleeding, quality of life, and costs. RESULTS: Seventeen of the 198 patients who received standard heparin (8.6 percent) and 14 of the 202 patients who received low-molecular-weight heparin (6.9 percent) had recurrent thromboembolism (difference, 1.7 percentage points; 95 percent confidence interval, -3.6 to 6.9). Major bleeding occurred in four patients assigned to standard heparin (2.0 percent) and one patient assigned to low-molecular-weight heparin (0.5 percent; difference, 1.5 percentage points; 95 percent confidence interval, -0.7 to 2.7). Quality of life improved in both groups. Physical activity and social functioning were better in the patients assigned to low-molecular-weight heparin. Among the patients in that group, 35 percent were never admitted to the hospital at all, and 40 percent were discharged early. This treatment was associated with a mean reduction in hospital days of 67 percent, ranging from 29 percent to 86 percent in the various study centers. CONCLUSIONS: In patients with proximal-vein thrombosis, treatment with low-molecular-weight heparin at home is feasible, effective, and safe.
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Cites
Leape, L. L., Brennan, T. A., Laird, N., Lawthers, A. G., Localio, A. R., Barnes, B. A., Hebert, L., Newhouse, J. P., Weiler, P. C., & Hiatt, H. (1991) · New England Journal of Medicine · doi:10.1056/nejm199102073240605 · Cited by 3,711
Resistance to Activated Protein C as a Basis for Venous Thrombosis
Svensson, P. J., & Dahlback, B. (1994) · New England Journal of Medicine · doi:10.1056/nejm199402243300801 · Cited by 1,102
Optimal Oral Anticoagulant Therapy in Patients with Mechanical Heart Valves
Cannegieter, S. C., Rosendaal, F. R., Wintzen, A. R., van der Meer, F. J. M., Vandenbroucke, J. P., & Briet, E. (1995) · New England Journal of Medicine · doi:10.1056/nejm199507063330103 · Cited by 908
de Haes, J., van Knippenberg, F., & Neijt, J. (1990) · British Journal of Cancer · doi:10.1038/bjc.1990.434 · Cited by 902
Oates, J. A., Wood, A. J. J., & Hirsh, J. (1991) · New England Journal of Medicine · doi:10.1056/nejm199105303242206 · Cited by 830
Hull, R. D., Raskob, G. E., Hirsh, J., Jay, R. M., Leclerc, J. R., Geerts, W. H., Rosenbloom, D., Sackett, D. L., Anderson, C., Harrison, L., et al. (1986) · New England Journal of Medicine · doi:10.1056/nejm198610303151801 · Cited by 722
Hull, R. D., Raskob, G. E., Pineo, G. F., Green, D., Trowbridge, A. A., Elliott, C. G., Lerner, R. G., Hall, J., Sparling, T., Brettell, H. R., et al. (1992) · New England Journal of Medicine · doi:10.1056/nejm199204093261502 · Cited by 700
Deep-Vein Thrombosis and the Incidence of Subsequent Symptomatic Cancer
Prandoni, P., Lensing, A. W. A., Büller, H. R., Cogo, A., Prins, M. H., Cattelan, A. M., Cuppini, S., Noventa, F., & ten Cate, J. W. (1992) · New England Journal of Medicine · doi:10.1056/nejm199210153271604 · Cited by 680
Self-citationPrandoni, P., Carta, M., Cogo, A., Ruol, A., Vigo, M., Casara, D., Lensing, A. W. A., Büller, H. R., & ten Cate, J. W. (1992) · The Lancet · doi:10.1016/0140-6736(92)91054-c · Cited by 583
Self-citationOates, J. A., Wood, A. J. J., & Hirsh, J. (1991) · New England Journal of Medicine · doi:10.1056/nejm199106273242606 · Cited by 563
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
Hyers, T. M., Agnelli, G., Hull, R. D., Morris, T. A., Samama, M., Tapson, V., & Weg, J. G. (2001) · Chest · doi:10.1378/chest.119.1_suppl.176s · Cited by 2,042
Incidence of Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism
Pengo, V., Lensing, A. W. A., Prins, M. H., Marchiori, A., Davidson, B. L., Tiozzo, F., Albanese, P., Biasiolo, A., Pegoraro, C., Iliceto, S., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa032274 · Cited by 1,828
Self-citationWeitz, J. I. (1997) · New England Journal of Medicine · doi:10.1056/nejm199709043371007 · Cited by 1,533
Metadata
- Authors
- Koopman, M. M. W., Prandoni, P., Piovella, F., Ockelford, P. A., Brandjes, D. P. M., van der Meer, J., Gallus, A. S., Simonneau, G., Chesterman, C. H., Prins, M. H., Bossuyt, P. M. M., de Haes, H., van den Belt, A. G. M., Sagnard, L., d'Azemar, P., & Büller, H. R.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1996-03-14
- Volume
- 334
- Issue
- 11
- Pages
- 682-687
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2342200163
- Cited by
- 1,111
- References
- 25
- FWCI
- 52.81
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Koopman, M. M. W., Prandoni, P., Piovella, F., Ockelford, P. A., Brandjes, D. P. M., van der Meer, J., Gallus, A. S., Simonneau, G., Chesterman, C. H., Prins, M. H., Bossuyt, P. M. M., de Haes, H., van den Belt, A. G. M., Sagnard, L., d'Azemar, P., & Büller, H. R. (1996). Treatment of Venous Thrombosis with Intravenous Unfractionated Heparin Administered in the Hospital as Compared with Subcutaneous Low-Molecular-Weight Heparin Administered at Home. New England Journal of Medicine. https://doi.org/10.1056/nejm199603143341102
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
