| Summary: | We compared the efficacy and safety of low molecular
weight heparins (LMWH) and unfractionated heparin (UFH) in the treatement of deep
venous thrombosis (DVT). A comparison between two daily subcutaneous injections
of LMWH against a single injection was also performed. DESIGN AND METHODS: The
study was performed by a meta-analysis. Clot improvement in venography,
recurrency, total mortality and major hemorrhages were assessed in 4,472 patients
with DVT from 21 studies treated with subcutaneous LMWH or UFH. RESULTS: An
improvement in clot reduction (odds ratio 0.73, 95% confidence interval 0.59 to
0.90, p = 0.004), a decrease in total mortality (0. 68, 0.50 to 0.91, p = 0.012)
and a lower incidence of hemorrhage (0. 65, 0.43 to 0.98, p = 0.047) were
observed in LMWH treated patients. There were no differences in recurrences
(0.78, 0.59 to 1.04, p = 0. 10). A single dose of LMWH was better than two in
reducing major bleeding (c2 = 4.99, p = 0.025); however, the two dose regimen was
more effective in clot reduction (c2 = 8.56, p = 0.004). INTERPRETATION AND
CONCLUSIONS: LMWH is superior to UFH in terms of safety and efficacy. A single
daily dose of LMWH dose is a suitable therapeutic regimen and could facilitate
the outpatient treatment of venous thromboembolism.
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