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Sede
Social
Colegio Oficial
de Médicos
de Barcelona
Paseo de la Bonanova, 47
08017 Barcelona
Telf.: 93 863 02 38
Fax: 93 863 05 58
secretariaseacv@telefonica.net |
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Lunes, 23 de Enero de 2012
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| Publicación
Española del Mes Nº 11 |
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Son las 01:37:54 horas del 5-2-2012 |
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Archivo PDF
(9 KB)
A Randomised Open-Label Trial Comparing Long-term
Sub-Cutaneous Low-Molecular-weight Heparin Compared with
Oral-Anticoagulant Therapy in the Treatment of Deep Venous
Thrombosis.
Romera A, Cairols MA, Vila-Coll R, Martí
X, Colomé E, Bonell A, Lapiedra O.
Eur J Vasc Endovasc Surg. 2008 Dec 31.
Department of Vascular Surgery, Hospital Universitari
de Bellvitge, Feixa Llarga, s/n 08907, L Hospitalet de
Llobregat, Barcelona, Spain.
Factor de impacto de Eur J Vasc Endovasc Surg
= 2.026.
OBJECTIVE: To evaluate whether low-molecular-weight
heparin (LMWH) could be equally (or more) effective than
oral anti-vitamin-K agents (AVK) in the long-term treatment
of deep venous thrombosis (DVT). 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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