Safety and efficacy of warfarin started early after submassive venous thrombosis or pulmonary embolism

Alexander Gallus, Jane Tillett, Jill Jackaman, Wendy Mills, Allan Wycherley

    Research output: Contribution to journalArticle

    263 Citations (Scopus)

    Abstract

    Two anticoagulant regimens, similar except for the timing of warfarin therapy, were compared in patients with clinically submassive venous thromboembolism (VTE). Warfarin was begun after 7 days of continuous intravenous heparin infusion in group L (127 patients) or within 3 days (average 1 day) of starting heparin in group S (139 patients), with similar outcomes. The frequency of symptomatic VTE recurrence during the hospital stay was 4.7% in group L and 3.6% in group S, and that of symptomless new perfusion defects 8.5% in group L and 3.9% in group S. On routine iodine-125-fibrinogen leg scanning of patients presenting with distal thrombosis (in the calf, popliteal, or distal femoral veins) 3.6% of group S but no group L patients had symptomless proximal extension. The incidence of bleeding was similar with both regimens. Outpatient follow-up showed no excess recurrent VTE in either treatment group. Early warfarin treatment significantly shortened hospital stay by an average of 3.9 days (30%) in patients admitted solely because of VTE.

    Original languageEnglish
    Pages (from-to)1293-1296
    Number of pages4
    JournalThe Lancet
    Volume328
    Issue number8519
    DOIs
    Publication statusPublished - 6 Dec 1986

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