Letters Section Editor: Robert M. Golub, MD, Senior Editor.
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.
Yan AT, Yan RT, Goodman SG. Excess Dosing of Antithrombotic Therapy in Non–ST-Segment Elevation Acute Coronary Syndromes. JAMA. 2006;295(16):1896-1897. doi:10.1001/jama.295.16.1896-a