Abstract | OBJECTIVE: DESIGN: A randomised, open-label trial. MATERIAL AND METHODS: In this trial, 241 patients with symptomatic proximal DVT of the lower limbs confirmed by duplex ultrasound scan were included. After initial LMWH, patients received 6 months of treatment with full therapeutic dosage of tinzaparin or acenocoumarol. The primary outcome was the 12-month incidence of symptomatic recurrent venous thrombo- embolism (VTE). Duplex scans were performed at 6 and 12 months. RESULTS: During the 12-month period, six patients (5%) of 119 who received LMWH and 13 (10.7%) of 122 who received AVK had recurrent VTE (p=0.11). In patients with cancer, recurrent VTE tended to be lower in the LMWH group (two of 36 [5.5%]) vs. seven of 33 [21.2%]; p=0.06). One major bleeding occurred in the LMWH group and three in the AVK group. Venous re-canalisation increased significantly at 6 months (73.1% vs. 47.5%) and at 12 months (91.5% vs. 69.2%) in the LMWH group. CONCLUSIONS:
Tinzaparin was more effective than AVK in achieving re-canalisation of leg thrombi. Long-term tinzaparin was at least as efficacious and safe as AVK for preventing recurrent VTE, especially in patients with cancer.
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Authors | A Romera, M A Cairols, R Vila-Coll, X Martí, E Colomé, A Bonell, O Lapiedra |
Journal | European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
(Eur J Vasc Endovasc Surg)
Vol. 37
Issue 3
Pg. 349-56
(Mar 2009)
ISSN: 1532-2165 [Electronic] England |
PMID | 19121589
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
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Chemical References |
- Anticoagulants
- Fibrin Fibrinogen Degradation Products
- Fibrinolytic Agents
- Heparin, Low-Molecular-Weight
- fibrin fragment D
- Tinzaparin
- Acenocoumarol
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Topics |
- Acenocoumarol
(therapeutic use)
- Administration, Oral
- Age Factors
- Anticoagulants
(therapeutic use)
- Female
- Fibrin Fibrinogen Degradation Products
(analysis)
- Fibrinolytic Agents
(therapeutic use)
- Heparin, Low-Molecular-Weight
(therapeutic use)
- Humans
- Injections, Subcutaneous
- International Normalized Ratio
- Male
- Middle Aged
- Neoplasms
(epidemiology)
- Prospective Studies
- Recurrence
- Risk Factors
- Tinzaparin
- Ultrasonography, Doppler, Duplex
- Venous Thrombosis
(diagnostic imaging, drug therapy)
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