Adriano Alatri, MD; Paolo Bucciarelli, MD; Marco Moia, MD
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Alatri A., Bucciarelli P., Moia M.; Subcutaneous Heparin for Deep Venous Thrombosis. Ann Intern Med. 1999;130:1027. doi: 10.7326/0003-4819-130-12-199906150-00009
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Published: Ann Intern Med. 1999;130(12):1027.
TO THE EDITOR:
Prandoni and colleagues (1) suggest that subcutaneous unfractionated heparin is an attractive approach to treating deep venous thrombosis compared with the use of low-molecular-weight-heparin (LMWH) because of the lower cost of unfractionated heparin. The main problems associated with the use of unfractionated heparin are the high variability of the anticoagulant response and the lack of an accepted method of standardization in the activated partial thromboplastin time, which is used to monitor treatment. Because unfractionated heparin treatment must be monitored (2), each hospital must establish its own therapeutic range based on a calibration curve of activated partial thromboplastin time against heparin levels assessed by anti-Xa activity. This procedure is difficult to perform, and it does not guarantee a full comparison of the anticoagulation regimens in different hospitals.
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