Background Low-molecular-weight heparin is known to be safeand effective for the initial treatment of patients with proximaldeep-vein thrombosis. However, its application to patients withpulmonary embolism or previous episodes of thromboembolism hasnot been studied.
Methods We randomly assigned 1021 patients with symptomaticvenous thromboembolism to fixed-dose, subcutaneous low-molecular-weightheparin (reviparin sodium) or adjusted-dose, intravenous unfractionatedheparin. Oral anticoagulant therapy with a coumarin derivativewas started concomitantly and continued for 12 weeks. Approximatelyone third of the patients had associated pulmonary embolism.The outcome events studied over the 12 weeks were symptomaticrecurrent venous thromboembolism, major bleeding, and death.We sought to determine whether low-molecular-weight heparinis at least equivalent to unfractionated heparin in patientswith venous thromboembolism.
Results Twenty-seven of the 510 patients assigned to low-molecular-weightheparin (5.3 percent) had recurrent thromboembolic events, ascompared with 25 of the 511 patients assigned to unfractionatedheparin (4.9 percent). The difference of 0.4 percentage pointindicates that the two therapies have equivalent value accordingto our predetermined definition of equivalence. Sixteen patientsassigned to low-molecular-weight heparin (3.1 percent) and 12patients assigned to unfractionated heparin (2.3 percent) hadepisodes of major bleeding (P = 0.63), and the mortality ratesin the two groups were 7.1 percent and 7.6 percent, respectively(P = 0.89).
Conclusions Fixed-dose, subcutaneous low-molecular-weight heparinis as effective and safe as adjusted-dose, intravenous unfractionatedheparin for the initial management of venous thromboembolism,regardless of whether the patient has pulmonary embolism ora history of venous thromboembolism.
Source Information
The Writing Committee of the Columbus Study (H.R. Büller, M. Gent, A.S. Gallus, J. Ginsberg, M.H. Prins, and R. Baildon) takes responsibility for the content of this article.
Address reprint requests to Professor J.W. ten Cate, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam Zuid-oost, the Netherlands.
Rodger, M. A. MD MSc, Kahn, S. R. MD MSc, Wells, P. S. MD MSc, Anderson, D. A. MD, Chagnon, I. MD, Le Gal, G. MD PhD, Solymoss, S. MD, Crowther, M. MD, Perrier, A. MD, White, R. MD, Vickars, L. MD, Ramsay, T. PhD MSc, Betancourt, M. T. MD MSc, Kovacs, M. J. MD
(2008). Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ
179: 417-426
[Abstract][Full Text]
Schulman, S., Beyth, R. J., Kearon, C., Levine, M. N.
(2008). Hemorrhagic Complications of Anticoagulant and Thrombolytic Treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest
133: 257S-298S
[Abstract][Full Text]
Kearon, C., Kahn, S. R., Agnelli, G., Goldhaber, S., Raskob, G. E., Comerota, A. J.
(2008). Antithrombotic Therapy for Venous Thromboembolic Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest
133: 454S-545S
[Abstract][Full Text]
Laporte, S., Mismetti, P., Decousus, H., Uresandi, F., Otero, R., Lobo, J. L., Monreal, M., the RIETE Investigators,
(2008). Clinical Predictors for Fatal Pulmonary Embolism in 15 520 Patients With Venous Thromboembolism: Findings From the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) Registry. Circulation
117: 1711-1716
[Abstract][Full Text]
Tapson, V. F.
(2008). Acute Pulmonary Embolism. NEJM
358: 1037-1052
[Full Text]
Janjigian, M. P., Muhs, B. E.
(2008). Current Treatment of Acute Lower Extremity Deep Venous Thrombosis. INT J LOW EXTREM WOUNDS
7: 15-20
[Abstract]
Spencer, F. A., Gore, J. M., Lessard, D., Douketis, J. D., Emery, C., Goldberg, R. J.
(2008). Patient Outcomes After Deep Vein Thrombosis and Pulmonary Embolism: The Worcester Venous Thromboembolism Study. Arch Intern Med
168: 425-430
[Abstract][Full Text]
Spyropoulos, A. C.
(2008). Outpatient-Based Primary and Secondary Thromboprophylaxis With Low-Molecular-Weight Heparin. CLIN APPL THROMB HEMOST
14: 63-74
[Abstract]
Anderson, J. L., Horne, B. D., Stevens, S. M., Grove, A. S., Barton, S., Nicholas, Z. P., Kahn, S. F.S., May, H. T., Samuelson, K. M., Muhlestein, J. B., Carlquist, J. F., for the Couma-Gen Investigators,
(2007). Randomized Trial of Genotype-Guided Versus Standard Warfarin Dosing in Patients Initiating Oral Anticoagulation. Circulation
116: 2563-2570
[Abstract][Full Text]
Tapson, V. F., Huisman, M. V.
(2007). Home at last? Early discharge for acute pulmonary embolism. Eur Respir J
30: 613-615
[Full Text]
Davies, C. W. H., Wimperis, J., Green, E. S., Pendry, K., Killen, J., Mehdi, I., Tiplady, C., Kesteven, P., Rose, P., Oldfield, W.
(2007). Early discharge of patients with pulmonary embolism: a two-phase observational study. Eur Respir J
30: 708-714
[Abstract][Full Text]
The van Gogh Investigators,
(2007). Idraparinux versus Standard Therapy for Venous Thromboembolic Disease. NEJM
357: 1094-1104
[Abstract][Full Text]
Nishioka, J., Goodin, S.
(2007). Low-molecular-weight heparin in cancer-associated thrombosis: treatment, secondary prevention, and survival. J Oncol Pharm Pract
13: 85-97
[Abstract]
Rimola, J., Perendreu, J., Falco, J., Fortuno, J. R., Massuet, A., Branera, J.
(2007). Percutaneous Arterial Embolization in the Management of Rectus Sheath Hematoma. Am. J. Roentgenol.
188: W497-W502
[Abstract][Full Text]
Krivak, T. C., Zorn, K. K.
(2007). Venous Thromboembolism in Obstetrics and Gynecology. Obstet Gynecol
109: 761-777
[Abstract][Full Text]
Nijkeuter, M., Sohne, M., Tick, L. W., Kamphuisen, P. W., Kramer, M. H. H., Laterveer, L., van Houten, A. A., Kruip, M. J. H. A., Leebeek, F. W. G., Buller, H. R., Huisman, M. V.
(2007). The Natural Course of Hemodynamically Stable Pulmonary Embolism: Clinical Outcome and Risk Factors in a Large Prospective Cohort Study. Chest
131: 517-523
[Abstract][Full Text]
Nutescu, E. A, Wittkowsky, A. K, Dobesh, P. P, Hawkins, D. W, Dager, W. E
(2006). Choosing the Appropriate Antithrombotic Agent for the Prevention and Treatment of VTE: A Case-Based Approach. The Annals of Pharmacotherapy
40: 1558-1570
[Abstract][Full Text]
Kearon, C., Ginsberg, J. S., Julian, J. A., Douketis, J., Solymoss, S., Ockelford, P., Jackson, S., Turpie, A. G., MacKinnon, B., Hirsh, J., Gent, M., for the Fixed-Dose Heparin (FIDO) Investigators,
(2006). Comparison of fixed-dose weight-adjusted unfractionated heparin and low-molecular-weight heparin for acute treatment of venous thromboembolism.. JAMA
296: 935-942
[Abstract][Full Text]
Piazza, G., Goldhaber, S. Z.
(2006). Acute Pulmonary Embolism: Part II: Treatment and Prophylaxis. Circulation
114: e42-e47
[Full Text]
de Moerloose, P., Samama, C. M., Motte, S.
(2006). Management of venous thromboembolism: [Traitement de la maladie thromboembolique veineuse].. Canadian J. Anesthesia
53: S80-S88
[Abstract][Full Text]
Sheehan, J. P., Walke, E. N.
(2006). Depolymerized holothurian glycosaminoglycan and heparin inhibit the intrinsic tenase complex by a common antithrombin-independent mechanism. Blood
107: 3876-3882
[Abstract][Full Text]
Ellis, M. H., Hadari, R., Tchuvrero, N., Shapira, S., Kovlenko, I., Kozmiakova, M., Zissin, R., Elis, A.
(2006). Hemorrhagic Complications in Patients Treated with Anticoagulant Doses of a Low Molecular Weight Heparin (Enoxaparin) in Routine Hospital Practice. CLIN APPL THROMB HEMOST
12: 199-204
[Abstract]
Rodger, M. A., Bredeson, C. N., Jones, G., Rasuli, P., Raymond, F., Clement, A. M., Karovitch, A., Brunette, H., Makropoulos, D., Reardon, M., Stiell, I., Nair, R., Wells, P. S.
(2006). The Bedside Investigation of Pulmonary Embolism Diagnosis Study: A Double-blind Randomized Controlled Trial Comparing Combinations of 3 Bedside Tests vs Ventilation-Perfusion Scan for the Initial Investigation of Suspected Pulmonary Embolism. Arch Intern Med
166: 181-187
[Abstract][Full Text]
Prandoni, P.
(2005). How I treat venous thromboembolism in patients with cancer. Blood
106: 4027-4033
[Abstract][Full Text]
Rashid, S T, Thursz, M R, Razvi, N A, Voller, R, Orchard, T, Rashid, S T, Shlebak, A A
(2005). Venous thromboprophylaxis in UK medical inpatients. JRSM
98: 507-512
[Abstract][Full Text]
Kucher, N., Quiroz, R., McKean, S., Sasahara, A. A, Goldhaber, S. Z
(2005). Extended enoxaparin monotherapy for acute symptomatic pulmonary embolism. Vasc Med
10: 251-256
[Abstract]
Harris, T, Meek, S
(2005). When should we thrombolyse patients with pulmonary embolism? A systematic review of the literature. Emerg. Med. J.
22: 766-771
[Abstract][Full Text]
Mismetti, P., Quenet, S., Levine, M., Merli, G., Decousus, H., Derobert, E., Laporte, S.
(2005). Enoxaparin in the Treatment of Deep Vein Thrombosis With or Without Pulmonary Embolism: An Individual Patient Data Meta-analysis. Chest
128: 2203-2210
[Abstract][Full Text]
Dager, W. E, King, J. H, Branch, J. M, Chow, S. L, Ferrer, R. E, Pak, S., Togioka, P. Y, White, R. H
(2005). Tinzaparin in Outpatients with Pulmonary Embolism or Deep Vein Thrombosis. The Annals of Pharmacotherapy
39: 1182-1187
[Abstract][Full Text]
Wells, P. S., Anderson, D. R., Rodger, M. A., Forgie, M. A., Florack, P., Touchie, D., Morrow, B., Gray, L., O'Rourke, K., Wells, G., Kovacs, J., Kovacs, M. J.
(2005). A Randomized Trial Comparing 2 Low-Molecular-Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Arch Intern Med
165: 733-738
[Abstract][Full Text]
Fiessinger, J.-N., Huisman, M. V., Davidson, B. L., Bounameaux, H., Francis, C. W., Eriksson, H., Lundstrom, T., Berkowitz, S. D., Nystrom, P., Thorsen, M., Ginsberg, J. S., for the THRIVE Treatment Study Investigators,
(2005). Ximelagatran vs Low-Molecular-Weight Heparin and Warfarin for the Treatment of Deep Vein Thrombosis: A Randomized Trial. JAMA
293: 681-689
[Abstract][Full Text]
Syed, F.F., Beeching, N.J.
(2005). Lower-limb deep-vein thrombosis in a general hospital: risk factors, outcomes and the contribution of intravenous drug use. QJM
98: 139-145
[Abstract][Full Text]
Pineo, G. F., Hull, R. D.
(2005). Low-Molecular-Weight Heparin for the Treatment of Venous Thromboembolism in the Elderly. CLIN APPL THROMB HEMOST
11: 15-23
[Abstract]
Kovacs, M.J., Kearon, C., Rodger, M., Anderson, D.R., Turpie, A.G.G., Bates, S.M., Desjardins, L., Douketis, J., Kahn, S.R., Solymoss, S., Wells, P.S.
(2004). Single-Arm Study of Bridging Therapy With Low-Molecular-Weight Heparin for Patients at Risk of Arterial Embolism Who Require Temporary Interruption of Warfarin. Circulation
110: 1658-1663
[Abstract][Full Text]
Karne, A., Shah, N. R.
(2004). Low-Molecular-Weight Heparin for Pulmonary Embolism. ANN INTERN MED
141: 407-407
[Full Text]
Hirsh, J., Raschke, R.
(2004). Heparin and Low-Molecular-Weight Heparin: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 188S-203S
[Abstract][Full Text]
Levine, M. N., Raskob, G., Beyth, R. J., Kearon, C., Schulman, S.
(2004). Hemorrhagic Complications of Anticoagulant Treatment: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 287S-310S
[Abstract][Full Text]
Buller, H. R., Agnelli, G., Hull, R. D., Hyers, T. M., Prins, M. H., Raskob, G. E.
(2004). Antithrombotic Therapy for Venous Thromboembolic Disease: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 401S-428S
[Abstract][Full Text]
Elting, L. S., Escalante, C. P., Cooksley, C., Avritscher, E. B. C., Kurtin, D., Hamblin, L., Khosla, S. G., Rivera, E.
(2004). Outcomes and Cost of Deep Venous Thrombosis Among Patients With Cancer. Arch Intern Med
164: 1653-1661
[Abstract][Full Text]
Aujesky, D. A., Cornuz, J., Bosson, J.-L., Bounameaux, H., Emmerich, J., Hull, R. D., Mackay, E., Perrier, A., Quan, H., Tsuyuki, R. T., Ghali, W. A.
(2004). Uptake of new treatment strategies for deep vein thrombosis: an international audit. Int J Qual Health Care
16: 193-200
[Abstract][Full Text]
Buller, H. R., Davidson, B. L., Decousus, H., Gallus, A., Gent, M., Piovella, F., Prins, M. H., Raskob, G., Segers, A. E.M., Cariou, R., Leeuwenkamp, O., Lensing, A. W.A., The Matisse Investigators*,
(2004). Fondaparinux or Enoxaparin for the Initial Treatment of Symptomatic Deep Venous Thrombosis: A Randomized Trial. ANN INTERN MED
140: 867-873
[Abstract][Full Text]
Pengo, V., Lensing, A. W.A., Prins, M. H., Marchiori, A., Davidson, B. L., Tiozzo, F., Albanese, P., Biasiolo, A., Pegoraro, C., Iliceto, S., Prandoni, P., the Thromboembolic Pulmonary Hypertension Study Gr,
(2004). Incidence of Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism. NEJM
350: 2257-2264
[Abstract][Full Text]
Writing Committee for the Galilei Investigators,
(2004). Subcutaneous Adjusted-Dose Unfractionated Heparin vs Fixed-Dose Low-Molecular-Weight Heparin in the Initial Treatment of Venous Thromboembolism. Arch Intern Med
164: 1077-1083
[Abstract][Full Text]
Quinlan, D. J., McQuillan, A., Eikelboom, J. W.
(2004). Low-Molecular-Weight Heparin Compared with Intravenous Unfractionated Heparin for Treatment of Pulmonary Embolism: A Meta-Analysis of Randomized, Controlled Trials. ANN INTERN MED
140: 175-183
[Abstract][Full Text]
Eichinger, S., Weltermann, A., Minar, E., Stain, M., Schonauer, V., Schneider, B., Kyrle, P. A.
(2004). Symptomatic Pulmonary Embolism and the Risk of Recurrent Venous Thromboembolism. Arch Intern Med
164: 92-96
[Abstract][Full Text]
Baldwin, Z. K., Comerota, A. J., Schwartz, L. B.
(2004). Catheter-Directed Thrombolysis for Deep Venous Thrombosis. VASC ENDOVASCULAR SURG
38: 1-9
[Abstract]
Linkins, L.-A., Choi, P. T., Douketis, J. D.
(2003). Clinical Impact of Bleeding in Patients Taking Oral Anticoagulant Therapy for Venous Thromboembolism: A Meta-Analysis. ANN INTERN MED
139: 893-900
[Abstract][Full Text]
The Matisse Investigators,
(2003). Subcutaneous Fondaparinux versus Intravenous Unfractionated Heparin in the Initial Treatment of Pulmonary Embolism. NEJM
349: 1695-1702
[Abstract][Full Text]
Lee, A. Y.Y., Levine, M. N., Baker, R. I., Bowden, C., Kakkar, A. K., Prins, M., Rickles, F. R., Julian, J. A., Haley, S., Kovacs, M. J., Gent, M., the Randomized Comparison of Low-Molecular-Weight,
(2003). Low-Molecular-Weight Heparin versus a Coumarin for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer. NEJM
349: 146-153
[Abstract][Full Text]
van Dongen, C. J. J., Vink, R., Hutten, B. A., Buller, H. R., Prins, M. H.
(2003). The Incidence of Recurrent Venous Thromboembolism After Treatment With Vitamin K Antagonists in Relation to Time Since First Event: A Meta-analysis. Arch Intern Med
163: 1285-1293
[Abstract][Full Text]
Tovey, C., Wyatt, S.
(2003). Diagnosis, investigation, and management of deep vein thrombosis. BMJ
326: 1180-1184
[Full Text]
Kucher, N., Printzen, G., Goldhaber, S. Z.
(2003). Prognostic Role of Brain Natriuretic Peptide in Acute Pulmonary Embolism. Circulation
107: 2545-2547
[Abstract][Full Text]
Kovacs, M. J., Rodger, M., Anderson, D. R., Morrow, B., Kells, G., Kovacs, J., Boyle, E., Wells, P. S.
(2003). Comparison of 10-mg and 5-mg Warfarin Initiation Nomograms Together with Low-Molecular-Weight Heparin for Outpatient Treatment of Acute Venous Thromboembolism: A Randomized, Double-Blind, Controlled Trial. ANN INTERN MED
138: 714-719
[Abstract][Full Text]
Raschke, R., Hirsh, J., Guidry, J. R.
(2003). Suboptimal Monitoring and Dosing of Unfractionated Heparin in Comparative Studies with Low-Molecular-Weight Heparin. ANN INTERN MED
138: 720-723
[Abstract][Full Text]
Hylek, E. M., Regan, S., Henault, L. E., Gardner, M., Chan, A. T., Singer, D. E., Barry, M. J.
(2003). Challenges to the Effective Use of Unfractionated Heparin in the Hospitalized Management of Acute Thrombosis. Arch Intern Med
163: 621-627
[Abstract][Full Text]
Masci, G., Magagnoli, M., Zucali, P. A., Castagna, L., Carnaghi, C., Sarina, B., Pedicini, V., Fallini, M., Santoro, A.
(2003). Minidose Warfarin Prophylaxis for Catheter-Associated Thrombosis in Cancer Patients: Can It Be Safely Associated With Fluorouracil-Based Chemotherapy?. JCO
21: 736-739
[Abstract][Full Text]
Schafer, A. I., Levine, M. N., Konkle, B. A., Kearon, C.
(2003). Thrombotic Disorders: Diagnosis and Treatment. ASH Education Book
2003: 520-539
[Abstract][Full Text]
Prandoni, P., Lensing, A. W. A., Piccioli, A., Bernardi, E., Simioni, P., Girolami, B., Marchiori, A., Sabbion, P., Prins, M. H., Noventa, F., Girolami, A.
(2002). Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood
100: 3484-3488
[Abstract][Full Text]
Dalen, J. E.
(2002). Pulmonary Embolism: What Have We Learned Since Virchow?: Treatment and Prevention. Chest
122: 1801-1817
[Full Text]
Meyer, G., Marjanovic, Z., Valcke, J., Lorcerie, B., Gruel, Y., Solal-Celigny, P., Le Maignan, C., Extra, J. M., Cottu, P., Farge, D.
(2002). Comparison of Low-Molecular-Weight Heparin and Warfarin for the Secondary Prevention of Venous Thromboembolism in Patients With Cancer: A Randomized Controlled Study. Arch Intern Med
162: 1729-1735
[Abstract][Full Text]
Cundiff, D. K.
(2002). Significant Omission in Antithrombotic Supplement. Chest
121: 1378-1379
[Full Text]
Kakkar, V. V., Hoppenstead, D. A., Fareed, J., Kadziola, Z., Scully, M., Nakov, R., Breddin, H. K.
(2002). Randomized trial of different regimens of heparins and in vivo thrombin generation in acute deep vein thrombosis. Blood
99: 1965-1970
[Abstract][Full Text]
Wood, K. E.
(2002). Major Pulmonary Embolism : Review of a Pathophysiologic Approach to the Golden Hour of Hemodynamically Significant Pulmonary Embolism. Chest
121: 877-905
[Abstract][Full Text]
Tait, R C
(2001). Anticoagulation in patients with thromboembolic disease. Thorax
56: ii30-37
[Full Text]
Garg, K., Mao, J.
(2001). Deep Venous Thrombosis: Spectrum of Findings and Pitfalls in Interpretation on CT Venography. Am. J. Roentgenol.
177: 319-323
[Full Text]
Hirsh, J., Anand, S. S., Halperin, J. L., Fuster, V.
(2001). Guide to Anticoagulant Therapy: Heparin : A Statement for Healthcare Professionals From the American Heart Association. Arterioscler. Thromb. Vasc. Bio.
21
: e9-e9
[Full Text]
Hamel, E., Pacouret, G., Vincentelli, D., Forissier, J. F., Peycher, P., Pottier, J. M., Charbonnier, B.
(2001). Thrombolysis or Heparin Therapy in Massive Pulmonary Embolism With Right Ventricular Dilation : Results From a 128-Patient Monocenter Registry. Chest
120: 120-125
[Abstract][Full Text]
Hirsh, J., Anand, S. S., Halperin, J. L., Fuster, V.
(2001). Guide to Anticoagulant Therapy: Heparin : A Statement for Healthcare Professionals From the American Heart Association. Circulation
103: 2994-3018
[Full Text]
Paterson, D. I., Schwartzman, K.
(2001). Strategies Incorporating Spiral CT for the Diagnosis of Acute Pulmonary Embolism : A Cost-effectiveness Analysis. Chest
119: 1791-1800
[Abstract][Full Text]
Garg, K., Kemp, J. L., Russ, P. D., Baron, A. E.
(2001). Thromboembolic Disease: Variability of Interobserver Agreement in the Interpretation of CT Venography with CT Pulmonary Angiography. Am. J. Roentgenol.
176: 1043-1047
[Abstract][Full Text]
Breddin, H. K., Hach-Wunderle, V., Nakov, R., Kakkar, V. V., The CORTES Investigators,
(2001). Effects of a Low-Molecular-Weight Heparin on Thrombus Regression and Recurrent Thromboembolism in Patients with Deep-Vein Thrombosis. NEJM
344: 626-631
[Abstract][Full Text]
Merli, G., Spiro, T. E., Olsson, C.-G., Abildgaard, U., Davidson, B. L., Eldor, A., Elias, D., Grigg, A., Musset, D., Rodgers, G. M., Trowbridge, A. A., Yusen, R. D., Zawilska, K., for the Enoxaparin Clinical Trial Group*,
(2001). Subcutaneous Enoxaparin Once or Twice Daily Compared with Intravenous Unfractionated Heparin for Treatment of Venous Thromboembolic Disease. ANN INTERN MED
134: 191-202
[Abstract][Full Text]
Ginsberg, J. A., Crowther, M. A., White, R. H., Ortel, T. L.
(2001). Anticoagulation Therapy. ASH Education Book
2001: 339-357
[Abstract][Full Text]
Hirsh, J., Warkentin, T. E., Shaughnessy, S. G., Anand, S. S., Halperin, J. L., Raschke, R., Granger, C., Ohman, E. M., Dalen, J. E.
(2001). Heparin and Low-Molecular-Weight Heparin Mechanisms of Action, Pharmacokinetics, Dosing, Monitoring, Efficacy, and Safety. Chest
119: 64S-94S
[Full Text]
Levine, M. N., Raskob, G., Landefeld, S., Kearon, C.
(2001). Hemorrhagic Complications of Anticoagulant Treatment. Chest
119: 108S-121S
[Full Text]
Hyers, T. M., Agnelli, G., Hull, R. D., Morris, T. A., Samama, M., Tapson, V., Weg, J. G.
(2001). Antithrombotic Therapy for Venous Thromboembolic Disease. Chest
119: 176S-193S
[Full Text]
Douketis, J. D., Foster, G. A., Crowther, M. A., Prins, M. H., Ginsberg, J. S.
(2000). Clinical Risk Factors and Timing of Recurrent Venous Thromboembolism During the Initial 3 Months of Anticoagulant Therapy. Arch Intern Med
160: 3431-3436
[Abstract][Full Text]
Collen, A., Smorenburg, S. M., Peters, E., Lupu, F., Koolwijk, P., Van Noorden, C., van Hinsbergh, V. W. M.
(2000). Unfractionated and Low Molecular Weight Heparin Affect Fibrin Structure and Angiogenesis in Vitro. Cancer Res.
60: 6196-6200
[Abstract][Full Text]
O'Shaughnessy, D., Miles, J., Wimperis, J.
(2000). UK patients with deep-vein thrombosis can be safely treated as out-patients. QJM
93: 663-667
[Abstract][Full Text]
Bauer, K. A.
(2000). Venous Thromboembolism in Malignancy. JCO
18: 3065-3067
[Full Text]
Hutten, B. A., Prins, M. H., Gent, M., Ginsberg, J., Tijssen, J. G. P., Buller, H. R.
(2000). Incidence of Recurrent Thromboembolic and Bleeding Complications Among Patients With Venous Thromboembolism in Relation to Both Malignancy and Achieved International Normalized Ratio: A Retrospective Analysis. JCO
18: 3078-3083
[Abstract][Full Text]
Zidane, M., Schram, M. T., Planken, E. W., Molendijk, W. H., Rosendaal, F. R., van der Meer, F. J. M., Huisman, M. V.
(2000). Frequency of Major Hemorrhage in Patients Treated With Unfractionated Intravenous Heparin for Deep Venous Thrombosis or Pulmonary Embolism: A Study in Routine Clinical Practice. Arch Intern Med
160: 2369-2373
[Abstract][Full Text]
(2000). Guidelines on diagnosis and management of acute pulmonary embolism. Eur Heart J
21: 1301-1336
Streiff, M. B.
(2000). Vena caval filters: a comprehensive review. Blood
95: 3669-3677
[Abstract][Full Text]
Heit, J. A., Mohr, D. N., Silverstein, M. D., Petterson, T. M., O'Fallon, W. M., Melton III, L. J.
(2000). Predictors of Recurrence After Deep Vein Thrombosis and Pulmonary Embolism: A Population-Based Cohort Study. Arch Intern Med
160: 761-768
[Abstract][Full Text]
Meignan, M., Rosso, J., Gauthier, H., Brunengo, F., Claudel, S., Sagnard, L., d'Azemar, P., Simonneau, G., Charbonnier, B.
(2000). Systematic Lung Scans Reveal a High Frequency of Silent Pulmonary Embolism in Patients With Proximal Deep Venous Thrombosis. Arch Intern Med
160: 159-164
[Abstract][Full Text]
Dolovich, L. R., Ginsberg, J. S., Douketis, J. D., Holbrook, A. M., Cheah, G.
(2000). A Meta-analysis Comparing Low-Molecular-Weight Heparins With Unfractionated Heparin in the Treatment of Venous Thromboembolism: Examining Some Unanswered Questions Regarding Location of Treatment, Product Type, and Dosing Frequency. Arch Intern Med
160: 181-188
[Abstract][Full Text]
Wakefield, T. W.
(2000). The Safety, Efficacy, and Cost Efficiency of Outpatient Treatment of Acute Deep Venous Thrombosis with Low Molecular Weight Heparin. PERSPECT VASC SURG ENDOVASC THER
13: 19-25
[Abstract]
Carman, T. L., Fernandez, B. B., Yusen, R. D., Haraden, B. M., Gage, B. F., Rubin, B. G., Botney, M. D.
(1999). Outpatient Treatment of Deep Venous Thrombosis. Chest
116: 1492-1493
[Full Text]
Anand, S. S., Bates, S., Ginsberg, J. S., Levine, M., Buller, H., Prins, M., Haley, S., Kearon, C., Hirsh, J., Gent, M.
(1999). Recurrent Venous Thrombosis and Heparin Therapy: An Evaluation of the Importance of Early Activated Partial Thromboplastin Times. Arch Intern Med
159: 2029-2032
[Abstract][Full Text]
Zed, P. J., Tisdale, J. E., Borzak, S.
(1999). Low-Molecular-Weight Heparins in the Management of Acute Coronary Syndromes. Arch Intern Med
159: 1849-1857
[Abstract][Full Text]
Spyropoulos, A. C., Harrison, L., Liebowitz, R. S.
(1999). Outpatient Protocols for Treatment of Venous Thromboembolism Using Low-Molecular-Weight Heparin: To Treat or Not to Treat at Home. Arch Intern Med
159: 1139-1140
[Full Text]
Aguilar, D., Goldhaber, S. Z.
(1999). Clinical Uses of Low-Molecular-Weight Heparins. Chest
115: 1418-1423
[Full Text]
Yusen, R. D., Haraden, B. M., Gage, B. F., Woodward, R. S., Rubin, B. G., Botney, M. D.
(1999). Criteria for Outpatient Management of Proximal Lower Extremity Deep Venous Thrombosis. Chest
115: 972-979
[Abstract][Full Text]
Fraser, J. D., Anderson, D. R.
(1999). Deep Venous Thrombosis: Recent Advances and Optimal Investigation with US. Radiology
211: 9-24
[Full Text]
Kuijer, P. M. M., Hutten, B. A., Prins, M. H., Buller, H. R.
(1999). Prediction of the Risk of Bleeding During Anticoagulant Treatment for Venous Thromboembolism. Arch Intern Med
159: 457-460
[Abstract][Full Text]
Vouyouka, A., Silver, D.
(1999). Is Low-Molecular-Weight Heparin the Answer for the Therapy of Acute Deep Vein Thrombosis?. VASC ENDOVASCULAR SURG
33: 125-128
Bousser, M.-G.
(1999). Cerebral Venous Thrombosis : Nothing, Heparin, or Local Thrombolysis?. Stroke
30: 481-483
[Full Text]
