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    Por favor, use este identificador para citar o enlazar este ítem:http://uvadoc.uva.es/handle/10324/3195

    Título
    Effect of anticoagulant therapy in tehe incidence of post-throbotic syndrome and recurrent thromboemboembolism : comparative study of euoxeparin versus coumarin
    Autor
    González Fajardo, José AntonioAutoridad UVA
    Martín Pedrosa, Miguel
    Castrodeza Sanz, José JavierAutoridad UVA
    Tamames Gómez, Sonia
    Vaquero Puerta, CarlosAutoridad UVA Orcid
    Año del Documento
    2008
    Editorial
    Society of Vascular Surgery
    Descripción
    Producción Científica
    Documento Fuente
    Journal of Vascular Surgery, Octubre 2008, vol. 48, n.4. p.953-959.
    Resumen
    Objective: We evaluated the effect of long-term anticoagulant treatment (enoxaparin vs coumarin) in patients with deep venous thrombosis (DVT) as to incidence of post-thrombotic syndrome (PTS) and recurrent venous thromboembolism. We also analyzed the impact of thrombus regression after the anticoagulant treatment for these two outcomes. Methods: A prospective study was designed in which 165 patients with symptomatic, unilateral, first-episode DVT were randomized to a long-term anticoagulant treatment with coumarin or enoxaparin during at least 3 months. The rate of thrombus regression was defined as the difference in Marder score after 3 months of treatment by venography. Follow-up was performed at 3, 6, and 12 months, and yearly thereafter for 5 years. Venous disease was related to pathologic severity of PTS according to the validated scale of Villalta as rated by a physician blinded to treatment. Recurrence of symptomatic venous thromboembolism was documented objectively. Results: The 5-year follow-up period was completed for 100 patients (enoxaparin, 56; coumarin, 44). A lesser incidence of PTS was observed in the enoxaparin group (39.3% absent, 19.6% severe) than in the coumarin group (29.5% absent, 29.5% severe), although this difference was not statistically significant. The accumulated recurrence rate was 19.3% with enoxaparin compared with 36.6% with coumarin (P .02). Although the mean Marder score was significantly improved in both groups (49.1% for enoxaparin vs 24.0% for coumarin; P .016), a lower reduction in thrombus size was associated with higher clinical events of recurrence (hazard ratio 1.97; 95% CI, 1.06-3.66; P .032). A significant inverse correlation was also found between the degree of thrombus regression at 3 months and the incidence at 5 years of PTS (P .007). Conclusions: Residual venous thrombosis is an important risk factor for recurrent thromboembolism and PTS. A greater reduction in thrombus size was associated with lesser clinical events of recurrence and consequently a lesser rate of PTS. However, despite a greater recanalization with enoxaparin, the incidence of PTS was similar between both treatment groups, probably because of the small sample size. Further investigations are needed to clarify the implication of the anticoagulant treatment in the severity of PTS. (J Vasc Surg 2008;48:953-9.)
    Materias (normalizadas)
    Síndrome post-trombótico
    Terapia quirúrgica
    ISSN
    0741-5214
    Revisión por pares
    SI
    DOI
    10.1016/j.jvs.2008.05.033
    Idioma
    eng
    URI
    http://uvadoc.uva.es/handle/10324/3195
    Derechos
    openAccess
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    • DEP11 - Artículos de revista [242]
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    Universidad de Valladolid

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