BMJ  2004;328 (8 May), doi:10.1136/bmj.328.7448.0-e

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LMW heparin effective for pulmonary embolus

Question Is low molecular weight heparin (LMWH) as effective as adjusted dose heparin in treating pulmonary embolism?

Synopsis Although LMWH is commonly used to treat deep vein thrombosis, some clinicians ask whether similar effectiveness has been shown for pulmonary embolism. The reviewers conducting this meta-analysis identified 12 studies including a total of 1951 patients by searching Medline, Embase, the Cochrane Library databases, and conference proceedings, and by contacting individual researchers and pharmaceutical companies. Two researchers independently reviewed the studies to determine their suitability for inclusion and extracted the data. They evaluated the studies for validity, finding that randomisation and allocation concealment were proper in all studies, with 90% or greater follow up in all the studies. There was homogeneity for all outcomes and no evidence of publication bias. The studies compared fixed dose, subcutaneously administered LMWH with intravenous, adjusted dose unfractionated heparin in patients with symptomatic or asymptomatic pulmonary embolism . . . [Full text of this article]

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Vadivelu Vasanthakumar
bmj.com, 8 Jun 2004 [Full text]