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Subcutaneous Heparin for Deep Venous Thrombosis
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IN RESPONSE:
We basically agree with Alatri and colleagues' comments. We did not perform a cost-efficacy analysis. Rather, we simply intended to provide operators with a practical and safe guideline for the initial treatment of deep venous thrombosis with subcutaneous unfractionated heparin. Unfractionated heparin is still the drug of choice and sometimes the only available drug for the treatment of this disease in many countries, including Italy.
We recognize that home treatment of deep venous thrombosis with LMWH is far less expensive than in-hospital treatment with unfractionated heparin (1). However, we believe that early discharge and even home treatment of venous thrombosis might be feasible with the use of subcutaneous unfractionated heparin in doses adjusted to a simple laboratory test. Our view is supported by a recent observation (2). An Italian multicenter study addressing this issue is currently in progress.
Paolo Prandoni, MD, PhD
University of Padua Medical School; Padua, Italy
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
