PMID- 15878544
OWN - NLM
STAT- MEDLINE
DCOM- 20050623
LR  - 20220408
IS  - 1078-5884 (Print)
IS  - 1078-5884 (Linking)
VI  - 29
IP  - 6
DP  - 2005 Jun
TI  - Long-term treatment of deep venous thrombosis with a low molecular weight heparin 
      (tinzaparin): a prospective randomized trial.
PG  - 638-50
AB  - OBJECTIVES: Evaluation of the effectiveness and safety of the low molecular 
      weight heparin (LMWH) tinzaparin versus unfractionated heparin (UFH) followed by 
      acenocoumarol in proximal deep venous thrombosis (DVT). DESIGN: Prospective, 
      randomized clinical trial. MATERIAL AND METHODS: Consecutive patients (n=108) 
      with acute leg DVT, confirmed by duplex, were randomized to either tinzaparin 
      alone or UFH and acenocoumarol for 6 months. Patients were evaluated 
      ultrasonographically at entry, 1, 3, 6 and 12 months. Thrombus regression, reflux 
      distribution and the incidence of complications were studied. A cost-analysis, 
      comparing the two treatments, was performed. RESULTS: The overall incidence of 
      major events (mortality, DVT recurrence, pulmonary embolism, major bleeding, 
      heparin-induced thrombocytopenia) was significantly different (p=0.035) in favor 
      of tinzaparin (7 versus 17 events). The ultrasonographic clot volume score (an 
      index of recanalization) decreased significantly in both treatment groups. 
      However, tinzaparin produced significantly more extended overall recanalization 
      from 3 months onwards (p<0.02). Thrombus regression was equivalent or in favor of 
      tinzaparin in the different DVT subgroups and venous segments, but the 
      statistical significance varied. Reflux showed non-significant differences 
      overall or in subgroups. A cost-analysis resulted in favor of LMWH. CONCLUSIONS: 
      A fixed daily dose of tinzaparin for 6 months was at least as effective and safe 
      as UFH and acenocoumarol. Regarding major events and recanalization, there was a 
      significant benefit in favor of tinzaparin. Long-term DVT treatment with 
      tinzaparin could represent an alternative to conventional treatment.
FAU - Daskalopoulos, M E
AU  - Daskalopoulos ME
AD  - Department of Vascular Surgery, Athens University Medical School, Athens, Greece.
FAU - Daskalopoulou, S S
AU  - Daskalopoulou SS
FAU - Tzortzis, E
AU  - Tzortzis E
FAU - Sfiridis, P
AU  - Sfiridis P
FAU - Nikolaou, A
AU  - Nikolaou A
FAU - Dimitroulis, D
AU  - Dimitroulis D
FAU - Kakissis, I
AU  - Kakissis I
FAU - Liapis, C D
AU  - Liapis CD
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20050331
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 7UQ7X4Y489 (Tinzaparin)
RN  - 9005-49-6 (Heparin)
RN  - I6WP63U32H (Acenocoumarol)
SB  - IM
CIN - Eur J Vasc Endovasc Surg. 2007 Sep;34(3):353-4. PMID: 17574456
MH  - Acenocoumarol/administration & dosage/adverse effects
MH  - Administration, Oral
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Heparin/administration & dosage/adverse effects
MH  - Heparin, Low-Molecular-Weight/*administration & dosage/adverse effects
MH  - Humans
MH  - Infusions, Intravenous
MH  - Injections, Subcutaneous
MH  - Long-Term Care
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - Pulmonary Embolism/diagnostic imaging/drug therapy
MH  - Recurrence
MH  - Tinzaparin
MH  - Ultrasonography, Doppler, Duplex
MH  - Vascular Patency/drug effects
MH  - Venous Thrombosis/diagnostic imaging/*drug therapy
EDAT- 2005/05/10 09:00
MHDA- 2005/06/24 09:00
CRDT- 2005/05/10 09:00
PHST- 2003/08/19 00:00 [received]
PHST- 2004/02/05 00:00 [accepted]
PHST- 2005/05/10 09:00 [pubmed]
PHST- 2005/06/24 09:00 [medline]
PHST- 2005/05/10 09:00 [entrez]
AID - S1078-5884(05)00067-5 [pii]
AID - 10.1016/j.ejvs.2004.02.029 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 2005 Jun;29(6):638-50. doi: 10.1016/j.ejvs.2004.02.029. 
      Epub 2005 Mar 31.