Cochrane · systematic review · CD006771
Subcutaneous unfractionated heparin for the initial treatment of venous thromboembolism
Robertson, L, Strachan, J · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
12
No studies
2
Included studies
NR
No studies 2 · 14.3%Ungraded 0 · 0%Very low 0 · 0%Low 12 · 85.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlySubcutaneous unfractionated heparin compared to intravenous unfractionated heparin for the initial treatment of venous thromboembolism
Population: people aged ≥ 18 years with a diagnosis of new or recurrent VTE
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic recurrent VTE at 3 months Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | OR 1.66 [0.89, 3.1] | 8 studies · 965 participants | Low Downgraded: risk of bias, imprecision |
Symptomatic recurrent DVT at 3 months Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | OR 3.29 [0.64, 17.06] | 1 study · 115 participants | Low Downgraded: imprecision |
PE at 3 months Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | OR 1.44 [0.73, 2.84] | 9 studies · 1161 participants | Low Downgraded: risk of bias, imprecision |
VTE‐related mortality at 3 months Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | OR 0.98 [0.2, 4.88] | 9 studies · 1168 participants | Low Downgraded: risk of bias, imprecision |
Major bleedingd (7 days ‐ 12 months) Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | OR 0.91 [0.42, 1.97] | 4 studies · 583 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortality (5 days to 12 months) Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | OR 1.74 [0.67, 4.51] | 8 studies · 972 participants | Low Downgraded: risk of bias, imprecision |
Asymptomatic VTE at 3 months Subcutaneous unfractionated heparin vs intravenous unfractionated heparin | no estimate extracted | NR | No studies |
Subcutaneous unfractionated heparin compared to low molecular weight heparin for the initial treatment of venous thromboembolism
Population: people aged ≥ 18 years with a diagnosis of new or recurrent VTE
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptomatic recurrent VTE at 3 months Subcutaneous unfractionated heparin vs low molecular weight heparin | OR 1.01 [0.63, 1.63] | 5 studies · 2156 participants | Low Downgraded: risk of bias, imprecision |
Symptomatic recurrent DVT at 3 months Subcutaneous unfractionated heparin vs low molecular weight heparin | OR 1.38 [0.73, 2.63] | 3 studies · 1566 participants | Low Downgraded: risk of bias, imprecision |
PE at 3 months Subcutaneous unfractionated heparin vs low molecular weight heparin | OR 0.84 [0.36, 1.96] | 5 studies · 1819 participants | Low Downgraded: risk of bias, imprecision |
VTE‐related mortality at 3 months Subcutaneous unfractionated heparin vs low molecular weight heparin | OR 0.53 [0.17, 1.67] | 8 studies · 2469 participants | Low Downgraded: risk of bias, imprecision |
Major bleedingd (3 months) Subcutaneous unfractionated heparin vs low molecular weight heparin | OR 0.72 [0.43, 1.2] | 5 studies · 2300 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortality (7 days ‐ 3 months) Subcutaneous unfractionated heparin vs low molecular weight heparin | OR 0.73 [0.5, 1.07] | 7 studies · 2272 participants | Low Downgraded: risk of bias, imprecision |
Asymptomatic VTE at 3 months Subcutaneous unfractionated heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Subcutaneous unfractionated heparin compared to Other treatment modalities for Venous thromboembolism‐ clinical efficacy
Population: Venous thromboembolism‐ clinical efficacy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Recurrent DVT during 3 months Subcutaneous unfractionated heparin vs Other treatment modalities | OR 1.68 [0.92, 3.04] | 4 studies · 1628 participants | Moderate Downgraded: risk of bias |
New clinical pulmonary embolism during heparin treatment Subcutaneous unfractionated heparin vs Other treatment modalities | OR 1.1 [0.46, 2.62] | 8 studies · 958 participants | Moderate Downgraded: risk of bias |
New clinical pulmonary embolism during 3 months Subcutaneous unfractionated heparin vs Other treatment modalities | OR 1.18 [0.54, 2.56] | 4 studies · 1626 participants | Moderate Downgraded: risk of bias |
Major bleeding Subcutaneous unfractionated heparin vs Other treatment modalities | OR 0.9 [0.6, 1.36] | 14 studies · 4390 participants | Very low Downgraded: risk of bias |
Minor bleeding Subcutaneous unfractionated heparin vs Other treatment modalities | OR 0.98 [0.71, 1.36] | 10 studies · 2755 participants | Moderate Downgraded: risk of bias |
Total death ‐ During 3 months Subcutaneous unfractionated heparin vs Other treatment modalities | OR 1.02 [0.67, 1.55] | 6 studies · 1887 participants | Moderate Downgraded: risk of bias |
VTE or bleeding related death during 3 months Subcutaneous unfractionated heparin vs Other treatment modalities | RD 0 | 7 studies · 2181 participants | Moderate Downgraded: risk of bias |