Subcutaneous UFH vs. LMWH for Acute VTE

The two types of heparin were equivalent, without need for coagulation monitoring, in a trial involving mostly outpatients.

We have evidence suggesting that subcutaneous unfractionated heparin (UFH) is as effective as low-molecular-weight heparin (LMWH) for acute venous thromboembolism (VTE) and that use of UFH in this setting may not require activated partial thromboplastin time (aPTT) monitoring. These researchers conducted a randomized trial of twice-daily, subcutaneous, fixed-dose UFH (first dose, 333 U/kg; then 250 U/kg) versus LMWH (dalteparin or enoxaparin; 100 IU/kg) in 697 patients with acute VTE at six university centers in Canada and New Zealand. Warfarin therapy, usually initiated concomitantly with heparin, was continued for at least 3 months. Outpatients made up 71% of the UFH group and 66% of the LMWH group.

Major bleeding rates during the first 10…

Reviewing Author

JoAnne M. Foody, MD