Dept. Angiology & Blood Coagulation "Marino Golinelli", S.Orsola-Malpighi University Hospital, Bologna, Italy.
Dept. Angiology & Blood Coagulation "Marino Golinelli", S.Orsola-Malpighi University Hospital, Bologna, Italy.
Thromb Res. 2014 Feb;133(2):196-202. doi: 10.1016/j.thromres.2013.12.005. Epub 2013 Dec 7.
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).
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.
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.
SVT patients with these factors may deserve a higher intensity and/or longer anticoagulant treatment.
背景/目的:评估 SteFlux(浅表血栓形成通量)临床试验中纳入的患者复发性事件的风险因素,该试验比较了不同剂量和持续时间的低分子肝素(那屈肝素)治疗浅表静脉血栓形成(SVT)。
患有至少 4 厘米长的内部或外部隐静脉或其侧支的急性 SVT 的门诊患者以双盲方式随机分为两组,分别接受那屈肝素 8500 UI aXa od 治疗 10 天,然后安慰剂治疗 20 天,或那屈肝素 8500 UI aXa od 治疗 10 天,然后那屈肝素 6400 UI aXa od 治疗 20 天,或那屈肝素 4250 UI aXa od 治疗 30 天。结果是在 664 例患者(M/F:246/418,平均年龄 65 岁)的前 30+/-3 天内出现症状性和无症状性深静脉血栓形成、肺栓塞和 SVT 复发或延伸的复合终点,并在 60+/-3 天随访期内记录。
在 664 例患者(M/F:246/418,平均年龄 65 岁)的 93 天内记录了 98 例(14.7%)结果。在调整治疗后,33 天内的结果与既往静脉血栓栓塞(VTE)和/或 SVT 和/或 VTE 家族史相关(比值比-OR:2.5;95%置信区间-95%CI:1.4-4.8;p=0.003)。停止 LMWH 治疗后,仅无静脉曲张(OR:2.5;95%CI 1.3-5.0;p=0.004)和既往 VTE 和/或 SVT 和/或 VTE 家族史(OR:1.9;95%CI:1.0-3.7;p=0.048)与结果显著相关。
具有这些因素的 SVT 患者可能需要更高强度和/或更长时间的抗凝治疗。