Kenneth M. Moser, MD; Peter F. Fedullo, MD
To the Editors: The meta-analysis reported by Hommes and colleagues (1) is likely to rekindle a long-simmering controversy about the relative safety and efficacy of subcutaneous compared with continuous intravenous heparin for the treatment of acute venous thromboembolism. Our reading of the extensive literature in this field has led us to conclude that these two (and other) methods of heparin administration appear to be equally safe and effective. Their meta-analysis, however, neglected the role of the activated partial thromboplastin time (APTT) response in monitoring.
Their inference that using subcutaneous heparin may allow us to "achieve early ambulation . . .
Moser KM, Fedullo PF. Subcutaneous Compared with Intravenous Heparin for Deep Vein Thrombosis. Ann Intern Med. ;117:265–266. doi: 10.7326/0003-4819-117-3-265
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Published: Ann Intern Med. 1992;117(3):265-266.
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