Antithrombin (AT) replacement in coronary artery bypass grafting procedures in three individuals with inherited antithrombin deficiency is described. All three had a significant personal or family history of thrombotic disease. All patients achieved satisfactory AT levels throughout bypass and in the postoperative period. All received heparin prophylaxis in the postoperative period. None suffered thrombotic or bleeding complications.

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tween the LMWH group and the placebo group in DVT incidence. The study enrolled 300 patients to 3 arms (100 patients each): an LMWH arm, a placebo arm, and a lowdose aspirin arm. A total of 249 subjects completed the study. Of the 82 evaluated patients assigned to placebo, 4 developed DVT compared with 0 of 82 patients receiving LMWH (P= .12 by Fisher exact test, 2-tailed). Three of the aspirin-treated patients developed DVT. After combining the aspirin and placebo groups, the authors still had statistically insignificant results (P=.10 compared with the LMWH group). Even after including superficial thrombophlebitis as thrombotic events, the results remained statistically insignificant (P=.07 for the LMWH group vs others). Finally, the authors used an inappropriate form of statistical analysis to double their sample size: they looked at each limb separately, although this maneuver violates necessary statistical assumptions of event independence. With 1 event in 164 LMWH-treated limbs and 14 events among 334 remaining limbs, the P value was .03 (not Ͻ.002, as stated in the abstract); this applies not to DVT specifically but to DVT plus superficial thrombophlebitis. The authors also claimed that there was a 25% risk reduction in DVT conferred by aspirin (3 DVTs in the aspirin group vs 4 in the placebo group) and that the P value for this comparison was Ͻ.05 (the correct P value is .72.).In contrast, 2 other randomized trials 5,6 demonstrate unequivocal efficacy of compression stockings: 1 DVT among 516 stocking wearers vs 31 DVTs among the 538 controls (PϽ.001, fixed-effects model). Use of stockings does not require a trip to the physician's office prior to every plane flight for a prescription and, unlike LMWH treatment prior to long flights, 8 is currently evidence based. 9

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