A randomized trial of the effect of low molecular weight heparin vs. warfarin on mortality in the long-term treatment of proximal vein thrombosis

Summary It has been shown that several different low molecular weight (LMW) heparins, given by a once- or twice-daily subcutaneous injection without laboratory monitoring, are as effective or even more effective than continuous intravenous, unfractionated heparin monitored by the activated partial thromboplastin time (APTT). One such study demonstrated a statistically significant decrease in mortality over the 3 month follow-up study. This was particularly striking in patients with cancer. Based on these findings, a multicentre, randomized clinical trial has been designed to compare the effect of long-term, once-daily LMW heparin with standard treatment using heparin and warfarin to ensure that equal numbers of cancer patients are in both groups. This will demonstrate whether or not the long-term use of LMW heparin can have a significant impact on mortality in patients who have proximal venous thrombosis with or without cancer.