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Letters |15 December 1996

Recurrence of Venous Thromboembolism after Unfractionated Heparin Therapy

Stuart K. Sutton, MD

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  • Health Services Association of Central New York, Syracuse, NY 13224.
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Drs. Kormas and Manoharan provide useful information that, as they indicate, is especially relevant for patients discharged soon after completion of intravenous heparin therapy. Recent actuarial guidelines imply that only 4 inpatient days are required to treat deep venous thrombosis (although 5 days seems to be the absolute minimum on the basis of the need for adequate overlap of warfarin and heparin therapy). In such an environment, clinicians must have an optimal understanding of these subtleties of disease management.
The results of Kormas and Manoharan's study updates the work of Thomas and colleagues [1], who showed the influence of heparin on measures of warfarin activity. This study showed that the effect of heparin on warfarin therapy (as measured by the British corrected ratio) was related to both the heparin dose and the initial British corrected ratio. More recently, Solomon and colleagues [2] reported the marked variability of the effect of heparin on the INR depending on which thromboplastin reagent was used to determine the prothrombin time.
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Sutton SK. Recurrence of Venous Thromboembolism after Unfractionated Heparin Therapy. Ann Intern Med. ;125:1013. doi: 10.7326/0003-4819-125-12-199612150-00029

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Published: Ann Intern Med. 1996;125(12):1013.

DOI: 10.7326/0003-4819-125-12-199612150-00029

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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