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Low-Molecular-Weight Heparin Compared with Intravenous Unfractionated Heparin for Treatment of Pulmonary Embolism: A Meta-Analysis of Randomized, Controlled Trials

Daniel J. Quinlan, MBBS; Andrew McQuillan, MBBS; and John W. Eikelboom, MBBS
[+] Article and Author Information

From King's College Hospital, London, United Kingdom; and Royal Perth Hospital and the School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.


Acknowledgments: The authors thank the authors of primary studies included in our meta-analysis (J. Cade, I. Campbell, D. Conen, S. Findik, A. Gallus, C. Kirchmaier, P. Kuijer, S. Laporte, S. Medlicott, P. Prandoni, and C. Thery) and R. Bejuit and S. Combe from Aventis Pharma; S. Wurzinger and F. Misselwitz from Knoll Pharmaceuticals; E. Lindenstrøm and L. Thomassen from Leo Pharmaceuticals; J. Brom and H. Bachmann from Novartis Pharmaceuticals; J. Schoenfelder, C. Fellenius, and A. Holmqvist, for Pharmacia Corporation; and J.-E. Joire from Sanofi-Synthelabo for assistance in verifying the accuracy of the data and providing missing data.

Potential Financial Conflicts of Interest:Honoraria: D.J. Quinlan (Aventis, Sanofi-Synthelabo), J.W. Eikelboom (Aventis, Pharmacia, Sanofi-Synthelabo); Grants received: J.W. Eikelboom (Aventis, Sanofi-Synthelabo).

Requests for Single Reprints: John W. Eikelboom, MBBS, Department of Haematology, Royal Perth Hospital, Wellington Street, Perth WA 6001, Australia; e-mail, john.eikelboom@health.wa.gov.au.

Current Author Addresses: Dr. Quinlan: Department of Radiology, King's College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom.

Drs. McQuillan and Eikelboom: Department of Haematology, Royal Perth Hospital, Wellington Street, Perth WA 6001, Australia.

Author Contributions: Conception and design: D.J. Quinlan, A. McQuillan, J. Eikelboom.

Analysis and interpretation of the data: D.J. Quinlan, A. McQuillan, J. Eikelboom.

Drafting of the article: D.J. Quinlan, A. McQuillan, J. Eikelboom.

Critical revision of the article for important intellectual content: D.J. Quinlan, A. McQuillan, J. Eikelboom.

Final approval of the article: D.J. Quinlan, A. McQuillan, J. Eikelboom.

Statistical expertise: J. Eikelboom.

Administrative, technical, or logistic support: J. Eikelboom.

Collection and assembly of data: D.J. Quinlan, A. McQuillan, J. Eikelboom.


Ann Intern Med. 2004;140(3):175-183. doi:10.7326/0003-4819-140-3-200402030-00008
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A protocol was prospectively developed in which the specific objectives, criteria for study selection, the approach to assessing study quality, primary and secondary outcomes, and statistical methods were defined.

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Figure 1.
Process of study selection

LMWH = low-molecular-weight heparin; PE = pulmonary embolism; RCT = randomized, controlled trial; UFH = unfractionated heparin.

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Figure 2.
Symptomatic venous thromboembolism at the end of treatment in trials comparing low-molecular-weight heparin (LMWH) with unfractionated heparin (UFH) for the treatment of acute pulmonary embolism

Data for the study by Hull and colleagues (32) are estimated from the published time-to-event curve. OR = odds ratio.

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Summary for Patients

Treatment of Pulmonary Embolism

The summary below is from the full report titled “Low-Molecular-Weight Heparin Compared with Intravenous Unfractionated Heparin for Treatment of Pulmonary Embolism. A Meta-Analysis of Randomized, Controlled Trials.” It is in the 3 February 2004 issue of Annals of Internal Medicine (volume 140, pages 175–183). The authors are D.J. Quinlan, A. McQuillan, and J.W. Eikelboom.

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