PMID- 10544902
OWN - NLM
STAT- MEDLINE
DCOM- 19991130
LR  - 20131121
IS  - 0340-6245 (Print)
IS  - 0340-6245 (Linking)
VI  - 82
IP  - 4
DP  - 1999 Oct
TI  - Long-term clinical follow-up in 265 patients with deep venous thrombosis 
      initially treated with either unfractionated heparin or dalteparin: a 
      retrospective analysis.
PG  - 1222-6
AB  - The primary objective of this retrospective study was to describe the frequency 
      of a post-thrombotic syndrome in 265 patients previously treated for deep venous 
      thrombosis (DVT). The secondary objectives were to document the frequency of 
      recurrent venous thromboembolism (VTE) and mortality, especially from malignant 
      disease. The patients were evaluated 5-14 years after inclusion in three 
      randomized trials comparing continuous intravenous (i.v.) infusion of 
      unfractionated heparin (UFH) (n = 85) with a low molecular weight heparin (LMWH), 
      dalteparin (n = 180). The median post-thrombotic score at follow-up was 2 (range 
      0-8). In a multiple step-wise regression analysis the postthrombotic score was 
      significantly higher among patients with initial proximal DVT (p = 0.0001) as 
      compared with those who had distal DVT. A recurrent venous thromboembolic event 
      was diagnosed in 29.4% of the patients treated with dalteparin and in 23.5% of 
      the patients treated with UFH (ns). A secondary risk factor for venous 
      thromboembolism and a longer duration of treatment with oral anticoagulants (OAC) 
      were significantly associated with a lower risk for recurrent VTE, whereas 
      malignant disease diagnosed during follow-up was associated with a higher risk. 
      During follow-up a total of 40.7% of patients had died. No difference in total 
      mortality or mortality from malignant disease was demonstrated between the two 
      drugs. In conclusion, a severe post-thrombotic syndrome occured relatively 
      infrequent. considering the long observation period. Proximal DVT was 
      significantly associated with a more severe post-thrombotic syndrome. After 14 
      years follow-up, no significant differences were observed in overall mortality, 
      mortality from malignant disease or recurrent VTE between UFH- and 
      dalteparin-treated patients. Malignant disease was a risk factor for recurrent 
      VTE, the presence of a secondary risk factor and a longer duration of treatment 
      with OAC decreased the risk for recurrent VTE.
FAU - Holmstrom, M
AU  - Holmstrom M
AD  - Karolinska Institute at the Dept of Haematology, Huddinge University Hospital, 
      Sweden.
FAU - Aberg, W
AU  - Aberg W
FAU - Lockner, D
AU  - Lockner D
FAU - Paul, C
AU  - Paul C
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Anticoagulants/*administration & dosage
MH  - Dalteparin/*administration & dosage
MH  - Follow-Up Studies
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Infusions, Intravenous
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - *Thrombophlebitis/drug therapy/mortality/physiopathology
EDAT- 1999/11/02 00:00
MHDA- 1999/11/02 00:01
CRDT- 1999/11/02 00:00
PHST- 1999/11/02 00:00 [pubmed]
PHST- 1999/11/02 00:01 [medline]
PHST- 1999/11/02 00:00 [entrez]
AID - 99101222 [pii]
PST - ppublish
SO  - Thromb Haemost. 1999 Oct;82(4):1222-6.