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April 26, 2006

Excess Dosing of Antithrombotic Therapy in Non–ST-Segment Elevation Acute Coronary Syndromes

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(16):1896-1897. doi:10.1001/jama.295.16.1896-a

To the Editor: Dr Alexander and colleagues1 studied excess dosing of antithrombotic therapy in patients with non–ST-segment elevation acute coronary syndromes. We support their conclusions that this occurs frequently and is associated with major bleeding. However, it is possible that the finding of a nonsignificant adjusted odds ratio for any excess dose of unfractionated heparin (1.08; 95% confidence interval, 0.94-1.26), which was also lower than that for other antithrombotic agents, was primarily related to the inherent difficulty in defining an excess dose regimen.

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