Diet as prophylaxis and treatment for venous thromboembolism?
Theoretical Biology and Medical Modelling, August 2010
David K Cundiff, Paul S Agutter, P Colm Malone, John C Pezzullo
Both prophylaxis and treatment of venous thromboembolism (VTE: deep venous thrombosis (DVT) and pulmonary emboli (PE)) with anticoagulants are associated with significant risks of major and fatal hemorrhage. Anticoagulation treatment of VTE has been the standard of care in the USA since before 1962 when the U.S. Food and Drug Administration began requiring randomized controlled clinical trials (RCTs) showing efficacy, so efficacy trials were never required for FDA approval. In clinical trials of 'high VTE risk' surgical patients before the 1980s, anticoagulant prophylaxis was clearly beneficial (fatal pulmonary emboli (FPE) without anticoagulants = 0.99%, FPE with anticoagulants = 0.31%). However, observational studies and RCTs of 'high VTE risk' surgical patients from the 1980s until 2010 show that FPE deaths without anticoagulants are about one-fourth the rate that occurs during prophylaxis with anticoagulants (FPE without anticoagulants = 0.023%, FPE while receiving anticoagulant prophylaxis = 0.10%). Additionally, an FPE rate of about 0.012% (35/28,400) in patients receiving prophylactic anticoagulants can be attributed to 'rebound hypercoagulation' in the two months after stopping anticoagulants. Alternatives to anticoagulant prophylaxis should be explored.
|Readers by professional status||Count||As %|
|Student > Master||13||24%|
|Student > Bachelor||10||19%|
|Student > Postgraduate||8||15%|
|Student > Ph. D. Student||3||6%|
|Readers by discipline||Count||As %|
|Medicine and Dentistry||21||39%|
|Nursing and Health Professions||6||11%|
|Agricultural and Biological Sciences||5||9%|
|Biochemistry, Genetics and Molecular Biology||2||4%|
|Sports and Recreations||2||4%|