Summary
In order to provide estimates of the risks of symptomatic osteoporosis and reduced
bone density in premenopausal women treated with long-term (greater than 1 month)
heparin therapy, we evaluated a cohort of 61 consecutive premenopausal women previously
treated with long-term heparin (cases) and a group of controls matched for age, parity
and duration between the last pregnancy and evaluation. All patients underwent dual
photon absorptiometry of the lumbar spine and single photon absorptiometry of the
wrist and most cases underwent plain lateral radiography of the thoracolumbar spine
in order to exclude silent fractures. Although none of the cases suffered symptomatic
fractures (0 of 61, 95% confidence intervals 0.0 to 5.9%), there was a significantly
greater proportion of cases than controls with bone density below our pre-defined
levels. The long-term implications of our findings are uncertain but because it is
possible that the reduction in bone density predisposes women to fractures, this potential
risk should be considered when treating women with long-term heparin.
