Stuart Keith Sutton, MD
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Sutton S.; Recurrence of Venous Thromboembolism after Treatment with Unfractionated Heparin. Ann Intern Med. 1996;124:532. doi: 10.7326/0003-4819-124-5-199603010-00014
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Published: Ann Intern Med. 1996;124(5):532.
TO THE EDITOR:
The study by de Valk and colleagues  satisfactorily achieved the authors' stated goal of “[defining] the optimal dose of danaparoid for further clinical testing in the treatment of venous thromboembolism.” Their conclusion of superior efficacy, however, is based on a comparison with a sub-standard regimen for administering unfractionated heparin. Adequate dosing requires the use of a formal nomogram such as that of Raschke and colleagues . Furthermore, therapeutic prolongation of the activated partial thromboplastin time must occur within 24 hours of the initiation of treatment . The lack of an appropriate nomogram suggests that the target activated partial thromboplastin time was not achieved . Consequently, the heparin recipients in de Valk and colleagues' study would be expected to have unacceptably high recurrence rates of deep venous thrombosis.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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