SummaryIn a randomized clinical trial the effect of subcutaneous heparin alone or in combination with dihydroergotamine or sulphinpyrazone in preventing postoperative deep vein thrombosis (DVT) was studied. Sodium heparin (5000 IU) was administered subcutaneously twice daily; dihydroergotamine (1/2 mg) was also administered subcutaneously twice daily, and sulphinpyrazone (400 mg) was administered orally or intravenously twice daily. Administration occurred for at least 7 days. The diagnosis DVT was made with the radiofibrinogen uptake test. 358 patients undergoing major elective abdominal surgery were allocated to three treatment groups: heparin alone (Hep), heparin + dihydroergotamine (DHE-Hep) and heparin + sulphinpyrazone (Sulph-Hep). The frequency of DVT was 14/114 in Hep, 10/115 in DHE-Hep and 20/114 in Sulph-Hep. These differences were not significant. After application of the “logistic regression” procedure of Cox (1) it turned out that the major risk factors for developing DVT were age, sex, weight, type of operation and presence of diabetes mellitus. Also a significant treatment influence was observed (p = 0.001). This treatment effect was most probably due to improvement in the DHE-Hep group.The results in the Sulph-Hep group were not significantly different from those in the Hep group. A risk index was formulated on the basis of the above mentioned risk factors by which the chance of occurrence of DVT during heparin prophylaxis in an individual patient could be predicted. Patients that should receive additional prophylactic treatment can be defined by using this risk index.

SummaryA review of experiments described in the literature discloses a lack of agreement about the influence of nutritional fats on blood coagulation and fibrinolysis. The numerous pertinent studies yielded contradictory results even if identical techniques were used.In our investigation, 17 normal subjects were given a breakfast containing 57 g saturated fats and one containing 54 g unsaturated fats. Before and 3 hrs after ingestion of the high-fat meal, blood was collected for determination of blood coagulation and fibrinolysis. There was no demonstrable difference between the two blood samples in terms of recalcification time of platelet-rich plasma in siliconized glass, euglobulin activity, fibrinolytic activity measured by lysis of plasminogen-poor and plasminogen-rich standard clots labelled with I131-fibrinogen, “activated fibrinolysis” (measuring the antiplasmin concentration) and the susceptibility to fibrinolysis of fibrin clots prepared in a standardized manner from fasting and hyperlipaemic plasma samples.In 6 normal subjects the experiments were expanded to encompass breakfasts with 118 saturated and 117 g unsaturated fats. After these high-fat meals, too, there was no demonstrable difference in recalcification time and in the various parameters of fibrinolysis.In order to establish whether atherosclerotic patients would show a different reaction to high-fat meals, the experiments were carried out also in 17 patients suffering from severe generalized atherosclerosis. These patients were given a low-fat breakfast, one with 57 g saturated fats and one with 54 g unsaturated fats. In this group, too, there were no demonstrable differences between the preprandial and postprandial data on blood coagulation and various parameters of fibrinolysis.