Indications

Why?

• Both are probably as effective as warfarin for long-term anticoagulation of patients with deep vein thrombosis. ^d
• There is less bleeding in heparin than warfarin. ^a
• However patients are at risk of osteopenia and thrombocytopenia on longterm heparin or LMWH, though there are fewer vertebral fractures on LMWH ^a

Long-term heparin causes fewer bleeds than warfarin, but vertebral fractures are common

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
proximal DVT a	subcutaneous heparin	warfarin	any bleed at 12 weeks	17%	89% (15% to 99%)	7 (4 to 23)
venous thromboembolism a	fragmin	heparin	vertebral fracture at 6 months	15%	83% (3% to 100%)	8 (4 to 240)