Análisis crítico de un artículo

Background: Few reports have addressed the value of unfractionated heparin (UFH) or low-molecular-weight heparin in treating the full spectrum of patients with venous thromboembolism (VTE), including recurrent VTE and pulmonary embolism. Methods: In an open, multicenter clinical trial, 720 consecuti...

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Autores principales:	Burotto P,Mauricio, Gabrielli N,Luigi, Crossley K,Nicolás
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2004
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900017
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spelling	oai:scielo:S0034-988720040009000172005-11-22Análisis crítico de un artículoBurotto P,MauricioGabrielli N,LuigiCrossley K,NicolásBackground: Few reports have addressed the value of unfractionated heparin (UFH) or low-molecular-weight heparin in treating the full spectrum of patients with venous thromboembolism (VTE), including recurrent VTE and pulmonary embolism. Methods: In an open, multicenter clinical trial, 720 consecutive patients with acute symptomatic VTE, including 119 noncritically ill patients (16.5%) with pulmonary embolism and 102 (14.2%) with recurrent VTE, were randomly assigned to treatment with subcutaneous UFH with dose adjusted by activated partial thromboplastin time by means of a weight-based algorithm (preceded by an intravenous loading dose), or fixed-dose (adjusted only to body weight) subcutaneous nadroparin calcium. Oral anticoagulant therapy was started concomitantly and continued for at least 3 months. We recorded the incidence of major bleeding during the initial heparin treatment and that of recurrent VTE and death during 3 months of follow-up. Results: Fifteen (4.2%) of the 360 patients assigned to UFH had recurrent thromboembolic events, as compared with 14 (3.9%) of the 360 patients assigned to nadroparin (absolute difference between rates, 0.3%; 95% confidence interval, -2.5% to 3.1%). Four patients assigned to UFH (1.1%) and 3 patients assigned to nadroparin (0.8%) had episodes of major bleeding (absolute difference between rates, 0.3%; 95% confidence interval, -1.2% to 1.7%). Overall mortality was 3.3% in each group. Conclusions: Subcutaneous UFH with dose adjusted by activated partial thromboplastin time by means of a weight-based algorithm is as effective and safe as fixed-dose nadroparin for the initial treatment of patients with VTE, including those with pulmonary embolism and recurrent VTEinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.132 n.9 20042004-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900017es10.4067/S0034-98872004000900017
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
description	Background: Few reports have addressed the value of unfractionated heparin (UFH) or low-molecular-weight heparin in treating the full spectrum of patients with venous thromboembolism (VTE), including recurrent VTE and pulmonary embolism. Methods: In an open, multicenter clinical trial, 720 consecutive patients with acute symptomatic VTE, including 119 noncritically ill patients (16.5%) with pulmonary embolism and 102 (14.2%) with recurrent VTE, were randomly assigned to treatment with subcutaneous UFH with dose adjusted by activated partial thromboplastin time by means of a weight-based algorithm (preceded by an intravenous loading dose), or fixed-dose (adjusted only to body weight) subcutaneous nadroparin calcium. Oral anticoagulant therapy was started concomitantly and continued for at least 3 months. We recorded the incidence of major bleeding during the initial heparin treatment and that of recurrent VTE and death during 3 months of follow-up. Results: Fifteen (4.2%) of the 360 patients assigned to UFH had recurrent thromboembolic events, as compared with 14 (3.9%) of the 360 patients assigned to nadroparin (absolute difference between rates, 0.3%; 95% confidence interval, -2.5% to 3.1%). Four patients assigned to UFH (1.1%) and 3 patients assigned to nadroparin (0.8%) had episodes of major bleeding (absolute difference between rates, 0.3%; 95% confidence interval, -1.2% to 1.7%). Overall mortality was 3.3% in each group. Conclusions: Subcutaneous UFH with dose adjusted by activated partial thromboplastin time by means of a weight-based algorithm is as effective and safe as fixed-dose nadroparin for the initial treatment of patients with VTE, including those with pulmonary embolism and recurrent VTE
author	Burotto P,Mauricio Gabrielli N,Luigi Crossley K,Nicolás
spellingShingle	Burotto P,Mauricio Gabrielli N,Luigi Crossley K,Nicolás Análisis crítico de un artículo
author_facet	Burotto P,Mauricio Gabrielli N,Luigi Crossley K,Nicolás
author_sort	Burotto P,Mauricio
title	Análisis crítico de un artículo
title_short	Análisis crítico de un artículo
title_full	Análisis crítico de un artículo
title_fullStr	Análisis crítico de un artículo
title_full_unstemmed	Análisis crítico de un artículo
title_sort	análisis crítico de un artículo
publisher	Sociedad Médica de Santiago
publishDate	2004
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872004000900017
work_keys_str_mv	AT burottopmauricio analisiscriticodeunarticulo AT gabriellinluigi analisiscriticodeunarticulo AT crossleyknicolas analisiscriticodeunarticulo
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Análisis crítico de un artículo

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