Dalteparin not better than unfractionated heparin for preventing DVT

Dalteparin was not better than unfractionated heparin for the prevention of deep vein thrombosis (DVT) among critically ill patients, according to an international study published in the New England Journal of Medicine.

At the same time, researchers with McMaster University, the Canadian Critical Care Trials Group and the Australian and New Zealand Intensive Care Society Clinical Trials Group, found that the proportion of patients with pulmonary emboli was significantly lower with dalteparin (1.3%) versus  heparin (2.3%) and fewer patients on dalteparin had heparin-induced thrombocytopenia.

In the multicenter trial, funded by the Canadian Institutes of Health Research and PROTECT (PROphylaxis for ThromboEmbolism in Clinical Care Trial), researchers examined 3,764 patients. They administered 5,000 IU of subcutaneous dalteparin once daily plus placebo once daily or unfractionated heparin (at a dose of 5,000 IU twice daily) while patients were in intensive care units. The median duration of use of both drugs was 7 days.

Investigators found no significant difference between the 2 groups on the rate of proximal leg DVT, which occurred in 5.1% of patients receiving dalteparin versus 5.8% receiving unfractionated heparin.

There were also no significant differences between the 2 groups in the rates of major bleeding or death in the hospital.

“Among critically ill patients, dalteparin was not superior to unfractionated heparin in decreasing the incidence of proximal deep-vein thrombosis,” the researchers wrote.