PMID- 11668421
OWN - NLM
STAT- MEDLINE
DCOM- 20020305
LR  - 20171116
IS  - 0094-6176 (Print)
IS  - 0094-6176 (Linking)
VI  - 27
IP  - 5
DP  - 2001 Oct
TI  - Reduction in thrombus extension and clinical end points in patients after initial 
      treatment for deep vein thrombosis with the fixed-dose body weight-independent 
      low molecular weight heparin certoparin.
PG  - 513-8
AB  - Low molecular weight heparin (LMWH) is effective in the treatment of acute deep 
      vein thrombosis (DVT) in adults. This has not been demonstrated for one LMWH 
      alone. The relationship between venographic changes due to LMWH therapy and 
      clinical outcome in the initial treatment period has not been reported. A pooled 
      analysis of two clinical trials was performed. The trials compared a fixed-dose, 
      body weight-independent, subcutaneous LMWH, certoparin (8000 antifactor Xa [aXa] 
      U twice a day [b.i.d.]), with an adjusted-dose intravenous unfractionated heparin 
      (UFH) with respect to venographic changes expressed as Marder score and 
      occurrence of recurrent venous thromboembolism, major bleeding, and mortality. 
      The Marder score was 23.2 +/- 8.4 in patients randomized to LMWH (n = 299 paired 
      phlebograms) and 23.9 +/- 8.9 in patients allocated to UFH (n = 297 paired 
      phlebograms) at entry (2p = 0.23) and 18.9 +/- 9.7 and 20.5 +/- 9.9 at the end of 
      the initial therapy (2p = 0.04), respectively. The composite outcome of recurrent 
      venous thromboembolism, major bleeding, and mortality occurred less frequently 
      during treatment with LMWH (n = 393) than it did with UFH (n = 404, 1.3% versus 
      5.0%, risk reduction [RR] 0.26, 95% confidence interval [CI] 0.11 to 0.63, 2p = 
      0.004). Single events of recurrent thromboembolism (2p = 0.12), major bleeding 
      (2p = 0.03), and mortality (2p = 0.12) were observed less frequently with LMWH. A 
      trend toward a lack of regression of thrombus size was observed in recurrent 
      venous thromboembolism (2p = 0.08). Body weight-independent LMWH significantly 
      reduces thrombus size and the incidence of composite outcome during the initial 
      treatment of acute proximal venous thrombosis compared with adjusted dose 
      intravenous UFH. The data indicate a relation between an unimproved Marder score 
      and a recurrent venous thromboembolism.
FAU - Harenberg, J
AU  - Harenberg J
AD  - j-harenberg@t-online.deDepartment of Medicine, University Hospital Mannheim, 
      Ruprecht-Karls University Heidelberg, Mannheim, German.
FAU - Huisman, M V
AU  - Huisman MV
FAU - Tolle, A R
AU  - Tolle AR
FAU - Breddin, H K
AU  - Breddin HK
FAU - Kirchmaier, C M
AU  - Kirchmaier CM
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - Semin Thromb Hemost
JT  - Seminars in thrombosis and hemostasis
JID - 0431155
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - V72OT3K19I (certoparin)
SB  - IM
MH  - Aged
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Hemorrhage/chemically induced
MH  - Heparin, Low-Molecular-Weight/*administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Phlebography
MH  - Recurrence
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Venous Thrombosis/complications/*drug therapy/mortality
EDAT- 2001/10/23 10:00
MHDA- 2002/03/07 10:01
CRDT- 2001/10/23 10:00
PHST- 2001/10/23 10:00 [pubmed]
PHST- 2002/03/07 10:01 [medline]
PHST- 2001/10/23 10:00 [entrez]
AID - 10.1055/s-2001-17953 [doi]
PST - ppublish
SO  - Semin Thromb Hemost. 2001 Oct;27(5):513-8. doi: 10.1055/s-2001-17953.