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Table 1 Randomized studies comparing the efficacy of thromboprophylaxis using LMWH, UFH or fondaparinux with placebo or no thromboprophylaxis in medical patients.

From: An update on prevention of venous thromboembolism in hospitalized acutely ill medical patients

Study Patients Detection of VTE Dose regimen Efficacy (thromboprophylaxis vs placebo or no thromboprophylaxis)
Gallus et al.1973 [17] Suspected AMI (n = 78) 125I-fibrinogen scanning UFH, 5000 IU s.c. t.i.d. VTE: 2.6% vs 22.5% (p = 0.05)
Belch et al. 1981 [18] HF and/or chest infection (n = 100) 125I-fibrinogen scanning UFH, 5000 IU s.c. t.i.d. VTE: 4% vs 26% (p < 0.01)
Halkin et al. 1982 [19] General medical (n = 1358) Mortality study UFH, 5000 IU s.c. b.i.d. Mortality: 7.8% vs 10.9% (p < 0.05)
Cade, 1982 [20] 1) Medical (n = 131)
2) Critically ill (n = 119)
125I-fibrinogen scanning UFH, 5000 IU s.c. b.i.d. 1) VTE: 2% vs 10% (p = NS)
2) VTE: 13% vs 29% (p < 0.05)
Ibarra-Perez et al. 1988 [21] Pulmonary disease, >40 years (n = 85) 125I-fibrinogen scanning, plus contrast venography UFH, 5000 IU s.c. b.i.d. VTE: 2.6% vs 26.1% (p < 0.0022)
Gårdlund, 1996 [22] Infectious disease (n = 19,751) Autopsy-verified pulmonary embolism UFH, 5000 IU s.c. b.i.d. Mortality: 5.3% vs 5.6% (p = NS)
International Stroke Trial, 1997 [23] Suspected acute ischaemic stroke (n = 19,435) Mortality study UFH, 5000 or 12,500 IU s.c. b.i.d. 14-day mortality: 9% vs 9.3% (p = NS)
6-month mortality: 22.5% vs 21.5% (p = NS)
Dahan et al. 1986 [24] Medical, >65 years (n = 270) 125I-fibrinogen scanning Enoxaparin 60 mg s.c. o.d. VTE: 3% vs 9% (p = 0.03)
Bergmann and Caulin, 1996 [25] Medical (n = 2472) Mortality study; autopsy-confirmed pulmonary embolism Nadroparin 7500 antiXa IU s.c. o.d. Mortality: 10.1% vs 10.3% (p = NS)
Samama et al. 1999 [3] Acutely ill medical (n = 1102) Bilateral venography or duplex ultrasonography Enoxaparin
1) 20 mg s.c. o.d.
2) 40 mg s.c. o.d.
1) VTE: 15.0% vs 14.9% (p = NS)
2) VTE: 5.5% vs 14.9% (p < 0.001)
Fraisse et al. 2000 [26] Chronic obstructive pulmonary disease (n = 223) Bilateral venography Nadroparin 3800 or 5700 IU antiXa s.c. o.d.1 VTE: 15.5% vs 28.2% (p = 0.045)
Leizorovicz et al. 2004 [4] Acutely ill medical (n = 3706) Compression ultrasonography Dalteparin 5000 IU s.c. o.d. VTE: 2.8% vs 5.0% (p = 0.0015)
Cohen et al. 2006 [5] Acutely ill elderly medical (n = 849) Bilateral venography Fondaparinux, 2.5 mg s.c. o.d. VTE: 5.6% vs 10.5% (p = 0.029)
  1. 1Dose adjusted based on patients' body weight. Patients in the range 45–70 kg received 3800 antiXa IU and patients in the range 71–110 kg received 5700 antiXa IU (i.e. 0.4 ml or 0.6 ml of a 9500 antiXa IU/ml concentrated solution of nadroparin, respectively).
  2. AMI, acute myocardial infarction; b.i.d., twice daily; HF, heart failure; LMWH, low-molecular-weight heparin; o.d., once daily; s.c. subcutaneously; t.i.d., three times daily; UFH, unfractionated heparin; VTE, venous thromboembolism.