Prolongation of enoxaparin therapy to one month promotes recanalization of occlusively thrombosed deep veins
- 作者: Vorob'eva N.M.1, Panchenko E.P.1, Ermolina O.V.1, Balakhonova T.V.1, Dobrovol'skiy A.B.1, Titaeva E.V.1, Khasanova Z.B.1, Postnov A.Y.1, Kirienko A.I.1, Vorobyeva NM2, Panchenko EP2, Ermolina OV2, Balakhonova TV2, Dobrovolsky AB2, Titaeva EV2, Khasanova ZB2, Postnov AY.2, Kirienko AI3
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隶属关系:
- Russian Cardiological Research Center, Moscow
- N.I. Pirogov Russian State Medical University, Moscow
- 期: 卷 83, 编号 8 (2011)
- 页面: 33-37
- 栏目: Editorial
- ##submission.dateSubmitted##: 10.04.2020
- ##submission.datePublished##: 15.08.2011
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30885
- ID: 30885
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Material and methods. Thirty patients were selected from 111 patients with a history of deep vein thrombosis (DVT) and/or pulmonary artery embolism according to the following criteria: the presence of occlusive thrombosis of one deep vein minimum; the absence of DVT for 12 months of follow-up. Patients of group 1 (n = 15) received standard therapy (UFH for at least 5 days) with switch to warfarin. Patients of group 2 (n = 15) received therapeutic doses of enoxaparin (1 mg/kg each 12 hours) for 30 days minimum with switch to warfarin. Follow-up was 12 months. Ultrasonic duplex angioscanning of the limbs was made at baseline, 1, 3, 6 and 12 months after treatment start.
Results. After follow-up month 1, 3 and 6 number of patients with occlusive DVT was significantly less in group 2. All the patients given enoxaparin achieved recanalization of OTDV within 3 months of treatment. OTDV recanalization was not achieved in 20% patients of group 1 even 12 months after treatment start.
Conclusion. Prolongation of enoxaparin treatment to 1 month followed by warfarin treatment is superior to standard UFH treatment followed by warfarin in providing recanalization of OTDV within 3 months of treatment. Moreover, this treatment predicts persistence of recanalization within 12 months of anticoagulant therapy.
作者简介
Natal'ya Vorob'eva
Email: natalyavorobjeva@mail.ru
Elizaveta Panchenko
Email: lizapanchenko@mail.ru
Ol'ga Ermolina
Email: olyak65@yandex.ru
Tat'yana Balakhonova
Email: tvbdoc@gmail.ru
Anatoliy Dobrovol'skiy
Email: abdobrovolsky@inbox.ru
Elena Titaeva
Email: evlti@mail.ru
Zukhra Khasanova
Email: khasanova@mail.ru
Anton Postnov
Email: a.postnov@mail.ru
Aleksandr Kirienko
Email: phlebo-union@mtu-net.ru
N Vorobyeva
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
E Panchenko
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
O Ermolina
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
T Balakhonova
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
A Dobrovolsky
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
E Titaeva
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
Z Khasanova
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
A Postnov
Russian Cardiological Research Center, MoscowRussian Cardiological Research Center, Moscow
A Kirienko
N.I. Pirogov Russian State Medical University, MoscowN.I. Pirogov Russian State Medical University, Moscow
参考
- Bernardi E., Bagatella P., Frulla M. et al. Postthrombotic syndrome: incidence, prevention, and management. Semin. Vasc. Med. 2001; 1: 71-80.
- Pesavento R., Bernardi E., Concolato A. et al. Postthrombotic syndrome. Semin. Thromb. Hemost. 2006; 32: 744-751.
- Kearon C., Kahn S. R., Agnelli G. et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008; 133 (Suppl.): 454S-545S.
- Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2008; 29: 2276-2315.
- Российские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология 2010; 4 (1): 4-37.
- Fihn S. D., McDonell M., Martin D. et al. Risk factors for complications of chronic anticoagulation. A multicenter study. Ann. Intern. Med. 1993; 118: 511-520.
- Pini M., Aiello S., Manotti C. et al. Low molecular weight heparin versus warfarin the prevention of recurrence after deep vein thrombosis. Thromb. Haemost. 1994;72: 191-197.
- Gonzalez-Fajardo J. A., Arreba E., Castrodeza J. et al. Venographic comparison of subcutaneous low-molecular weight heparin with oral anticoagulant therapy in the long-term treatment of deep venous thrombosis. J. Vasc. Surg. 1999; 30: 283-292.
- Meyer G., Marjanovic Z., Valcke J. et al. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patient with cancer. Arch. Intern. Med. 2002; 162: 1729-1735.
- Viega F., Escriba A., Maluenda M. P. et al. Low molecular weight heparin (enoxaparin) versus oral anticoagulant therapy (acenocoumarol) in the long-term treatment of deep venous thrombosis in the elderly: a randomized trial. Thromb. Haemost. 2000; 84: 559-564.
- lorio A., Guercini F., Pini M. Low-molecular-weight heparin for the long-term treatment of symptomatic venous thromboembolism: meta-analysis of the randomized comparisons with oral anticoagulant. J. Thromb. Haemost. 2003; 1: 1906- 1913.
- van der Heijden J. F., Hutten B. A., Buller H. R. et al. Vitamin К antagonists or low-molecular-weight heparin for the long term treatment of symptomatic venous thromboembolism (Cochrane Review). The Cochrane Library. Oxford, UK: Update Software; 2002; issue 4.
- Lee A. Y., Levine M. N., Baker R. I. et al. Low-molecular-weight heparin versus a coumarin for prevention of recurrent venous thromboembolism in patient with cancer. N. Engl. J. Med. 2003; 349: 146-153.
- Hull R., Pineo G. F., Mah A. et al. A randomized trial evaluating long-term low-molecular-weight heparin therapy for three months versus intravenous heparin followed by warfarin sodium [abstract]. Blood 2002; 100: 148a.
- Hull R., Pineo G. F., Mah A. et al. Safety and efficacy results for a study investigating the long-term out-of-hospital treatment of patients with proximal-vein thrombosis using subcutaneous low-molecular-weight heparin versus warfarin [abstract]. Thromb. Haemost. 2001; Suppl.: Abstract. ОС1647.
- Воробьева Н. М., Панченко Е. П., Кириенко А. И. и др. Варфарин или эноксапарин: что назначить больному венозным тромбозом в первый месяц лечения? Тер. apx. 2009; 81 (9): 57-61.
- Воробьева Н. М., Панченко Е. П., Андрияшкин В. В. и др. Факторы, определяющие эффективность антикоагулянтной терапии у больных с венозными тромбоэмболическими осложнениями. Флебология 2010; 4 (3): 13-20.
- Панченко Е. П., Голицын С. П., Комаров А. Л. и др. Сравнительное изучение эффективности и безопасности эноксапарина и аценокумарола при восстановлении синусового ритма у больных мерцательной аритмией без поражения клапанного аппарата сердца. Сердеч. недостат. 2006; 4 (4): 178-182.
- Hoppensteadt D. A., Walenga J. M., Fasanella A. et al. TFPI antigen levels in normal human volunteers after intravenous and subcutaneous administration of unfractionated heparin and a low molecular weight heparin. Thromb. Res.1995; 77: 175- 185.
- Bajzar L., Nesheim M. E., Tracy P. B. The profibrinolytic effect of activated protein С in clots formed from plasma is ТAFI-dependent. Blood 1996; 88: 2093-2100.
- Ninet J., Duroux P. A randomized trial of subcutaneous low molecular weight heparin (CY 216) compared with intravenous unfractionated heparin in the treatment of DVT. A collaborative European multicentre study. Thromb. Haemost. 1991; 65: 251-255.
- Simonneau G., Charbonnier В., Decousus H. et al. Subcutaneous low-molecular-weight heparin compared with continuous unfractionated heparin in the treatment of proximal deep vein thrombosis. Arch. Intern. Med. 1993; 153: 1541-1546.
- Vorobyeva N. M., Panchenko E. P., Kirienko A. I. et al. Prolongation of enoxaparin therapy to one month facilitates restoration of blood flow and improves 1-year outcomes in patients with venous thromboembolism. Eur. Heart J. 2010; 31 (Suppl. 1): 979.
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