Benilde Cosmi1, Massimo Filippini2, Fausto Campana3, Giampiero Avruscio4, Angelo Ghirarduzzi5, Eugenio Bucherini6, Giuseppe Camporese7, Davide Imberti8, Cristina Legnani2, Gualtiero Palareti2. 1. Dept. Angiology & Blood Coagulation "Marino Golinelli", S.Orsola-Malpighi University Hospital, Bologna, Italy. Electronic address: benilde.cosmi@unibo.it. 2. Dept. Angiology & Blood Coagulation "Marino Golinelli", S.Orsola-Malpighi University Hospital, Bologna, Italy. 3. Vascular Medicine Unit, Bufalini Hospital, Cesena, Italy. 4. Dept. Angiology, S.Antonio Hospital, Padua, Italy. 5. Angiology Unit - Dept of Internal Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. 6. Unit of Vascular Medicine and Angiology, Civic Hospital of Faenza, Faenza, Italy. 7. Unit of Angiology, University Hospital of Padua, Padua, Italy. 8. Dept. of Internal Medicine, G. da Saliceto Hospital, Piacenza, Italy.
Abstract
BACKGROUND/AIMS: To evaluate risk factors for recurrent events in patients enrolled in the SteFlux (Superficial Thromboembolism Fluxum) clinical trial which compared different doses and duration of low molecular weight heparin (parnaparin) for superficial vein thrombosis (SVT). MATERIALS AND METHODS: Outpatients with acute SVT of at least 4 cm in length of the internal or external saphenous veins or their collaterals were randomized in a double blind fashion to receive either parnaparin 8500 UI aXa od for ten days followed by placebo for 20 days or 8500 UI aXa od for ten days followed by 6400 UI aXa od for 20 days or 4250 UI aXa od for 30 days. Outcomes were the composite of symptomatic and asymptomatic deep vein thrombosis, pulmonary embolism and SVT recurrence or extension in the first 30+/-3 days with a 60+/-3 day follow-up. RESULTS: 98 outcomes (14.7%) were recorded during 93 days among 664 patients (M/F: 246/418, mean age 65). After correction for treatment, outcomes during 33 days were associated with previous venous thromboembolism (VTE) and/or SVT and/or family history of VTE (odds ratio-OR: 2.5; 95% confidence interval - CI: 1.4-4.8; p=0.003). After stopping LMWH treatment, only the absence of varicose veins (OR: 2.5; 95% CI 1.3-5.0; p=0.004) and previous VTE and/or SVT and/or family history of VTE (OR: 1.9; 95% CI:1.0-3.7; p=0.048) were significantly associated with outcomes. CONCLUSIONS: SVT patients with these factors may deserve a higher intensity and/or longer anticoagulant treatment.
RCT Entities:
BACKGROUND/AIMS: To evaluate risk factors for recurrent events in patients enrolled in the SteFlux (Superficial Thromboembolism Fluxum) clinical trial which compared different doses and duration of low molecular weight heparin (parnaparin) for superficial vein thrombosis (SVT). MATERIALS AND METHODS: Outpatients with acute SVT of at least 4 cm in length of the internal or external saphenous veins or their collaterals were randomized in a double blind fashion to receive either parnaparin 8500 UI aXa od for ten days followed by placebo for 20 days or 8500 UI aXa od for ten days followed by 6400 UI aXa od for 20 days or 4250 UI aXa od for 30 days. Outcomes were the composite of symptomatic and asymptomatic deep vein thrombosis, pulmonary embolism and SVT recurrence or extension in the first 30+/-3 days with a 60+/-3 day follow-up. RESULTS: 98 outcomes (14.7%) were recorded during 93 days among 664 patients (M/F: 246/418, mean age 65). After correction for treatment, outcomes during 33 days were associated with previous venous thromboembolism (VTE) and/or SVT and/or family history of VTE (odds ratio-OR: 2.5; 95% confidence interval - CI: 1.4-4.8; p=0.003). After stopping LMWH treatment, only the absence of varicose veins (OR: 2.5; 95% CI 1.3-5.0; p=0.004) and previous VTE and/or SVT and/or family history of VTE (OR: 1.9; 95% CI:1.0-3.7; p=0.048) were significantly associated with outcomes. CONCLUSIONS: SVT patients with these factors may deserve a higher intensity and/or longer anticoagulant treatment.
Authors: Lauren N Bell; Richard L Berg; John R Schmelzer; Hong Liang; Joseph J Mazza; Rajan Kanth; Christopher L Bray; Calixto B Zaldivar; Steven H Yale Journal: J Thromb Thrombolysis Date: 2017-01 Impact factor: 2.300
Authors: Konstantinos M Nikolakopoulos; Stavros K Kakkos; Chrysanthi P Papageorgopoulou; Ioannis A Tsolakis Journal: Vasc Specialist Int Date: 2018-03-31