Low molecular weight heparin versus coumarin in the prevention of recurrence after deep vein thrombosis

In numerous clinical trials low molecular weight heparins (LMWHs) have proven to be highly efficacious and safe in preventing thromboembolic complications. There is also a strong evidence that for the prevention of recurrence after deep venous thrombosis LMWHs lead to results comparable to those of dose-adjusted coumarin: in a monocentric randomized prospective study 200 patients after conservatively or surgically treated deep vein thrombosis received either a fixed dose of LMWH (5000 U anti-Xa: Fragmin P forte) s.c. or dose-adjusted coumarin (Marcumar) p.o. during a period of 3-6 months. During a follow-up of 12 months there was no significant difference between both groups regarding recurrence of deep vein thrombosis but three major bleeding complications in the coumarin-group (none in the LMWH-group) occurred.