title: Safety and efficacy of warfarin started early after submassive venous thrombosis or pulmonary embolism.
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.
mesh_terms: D000368:Aged; D002986:Clinical Trials as Topic; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000401:mortality; D011897:Random Allocation; D012008:Recurrence; D013924:Thrombophlebitis / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors; D014859:Warfarin / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014859:Warfarin; D006493:Heparin