This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Coagulation Disorders  • Men's Health, Other  • Venous Thromboembolism  • Adverse Effects  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Kearon and colleagues¹ compared the use of fixed-dose, weight-adjusted unfractionated heparin and low-molecular-weight heparin for acute venous thromboembolism (VTE). One of the key findings was the small risk of major bleeding at 10 days, although there was a non–statistically significant difference at 3 months (1.7% for the unfractionated heparin group vs 3.4% for the low-molecular-weight heparin group).

We believe that the definitions of bleeding are too heterogeneous and that further clarification of the underlying etiology of the bleeding is required. In this study, bleeding was defined as major if it was clinically overt and associated with a decrease in hemoglobin level of at least 2.0 g/dL, involved a need for transfusion of 2 or more units of red blood cells, or involved a critical site (eg, retroperitoneal, intracranial). These are less stringent criteria than the TIMI classification,² which requires a decrease in hemoglobin of more than . . . [Full Text of this Article]

Neeraj Bhala, MRCP
nijbhala@doctors.org.uk

Ashit Shah, MRCP; Andrew King, MRCP; Chakri Molugu, MRCP
Department of Gastroenterology
University Hospital of Coventry & Warwick
Walsgrave, Coventry, England

RELATED LETTERS

Fixed-Dose Unfractionated Heparin vs Low-Molecular-Weight Heparin for Venous Thromboembolism
Huichun Zhan and Haoyi Zheng
JAMA. 2007;297(3):261-262.
EXTRACT | FULL TEXT  

Fixed-Dose Unfractionated Heparin vs Low-Molecular-Weight Heparin for Venous Thromboembolism
Jonathan Lee Edwards
JAMA. 2007;297(3):262.
EXTRACT | FULL TEXT  

Fixed-Dose Unfractionated Heparin vs Low-Molecular-Weight Heparin for Venous Thromboembolism
Darrell W. Harrington and Ayad Jindeel
JAMA. 2007;297(3):262.
EXTRACT | FULL TEXT  

Fixed-Dose Unfractionated Heparin vs Low-Molecular-Weight Heparin for Venous Thromboembolism—Reply
Clive Kearon, Jeffrey S. Ginsberg, Jim A. Julian, Michael Gent, and for the Fixed-Dose Heparin (FIDO) Investigators
JAMA. 2007;297(3):263.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Comparison of Fixed-Dose Weight-Adjusted Unfractionated Heparin and Low-Molecular-Weight Heparin for Acute Treatment of Venous Thromboembolism
Clive Kearon, Jeffrey S. Ginsberg, Jim A. Julian, James Douketis, Susan Solymoss, Paul Ockelford, Sharon Jackson, Alexander G. Turpie, Betsy MacKinnon, Jack Hirsh, Michael Gent, and for the Fixed-Dose Heparin (FIDO) Investigators
JAMA. 2006;296(8):935-942.
ABSTRACT | FULL TEXT