Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis

Article Abstract:

Long-term anticoagulation for preventing recurrent deep vein thrombosis provides no additional benefit over short-term anticoagulation. In a study of 267 patients who received anticoagulation for three months or one year, the rate of recurrence at two years was the same in both groups.

Dosage and administration, Thrombosis, Deep vein, Deep vein thrombosis

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Extended oral anticoagulant therapy after a first episode of pulmonary embolism

Article Abstract:

Background: The optimal duration of oral anticoagulant treatment after a first episode of pulmonary embolism remains uncertain. Objective: To evaluate the long-term clinical benefit of extending a 3-month course of oral anticoagulant therapy to 6 months (pulmonary embolism associated with temporary risk factors) or to 1 year (idiopathic pulmonary embolism) in patients with a first episode of pulmonary embolism. Design: Multicenter randomized study with independent, blinded assessment of the outcome events. Setting: 19 Italian hospitals. Patients: 326 patients who had had 3 months of oral anticoagulant therapy without experiencing recurrence or bleeding. Measurements: The primary study outcome was recurrence of symptomatic, objectively confirmed venous thromboembolism. Results: Among 165 patients assigned to extended anticoagulant therapy, 15 patients (9%) had a recurrence of venous thromboembolism (3.1% per patient-year; average follow-up, 34.9 months), as compared with 18 of 161 patients (11.2%) assigned to discontinue treatment (4.1% per patient-year; average follow-up, 32.7 months); the rate ratio was 0.81 (95% CI, 0.42 to 1.56). All but one of the recurrences occurred after anticoagulant treatment was discontinued. Nineteen recurrences (57.6%) were episodes of pulmonary embolism, two of which were fatal. Three major bleeding episodes were observed during extended anticoagulation (1.8%). Among patients with idiopathic venous thromboembolism, 11 of 90 patients assigned to extended anticoagulation and 11 of 91 patients assigned to discontinue treatment experienced a recurrence (relative risk, 0.99 [CI, 0.45 to 2.16]). Conclusion: Patients with pulmonary embolism have a substantial risk for recurrence after discontinuation of oral anticoagulation, regardless of treatment duration. Physicians should try to identify patients who are at high risk for recurrent venous thromboembolism and are therefore potential candidates for indefinite oral anticoagulant therapy.

Pharmaceutical Preparation Manufacturing, Pharmaceutical preparations, Anticoagulant Preparations, Pulmonary embolism, Recurrence (Disease), Author Abstract

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Enoxaparin plus compression stockings compared with compression stockings alone in the prevention of venous thromboembolism after elective neurosurgery

Article Abstract:

The drug enoxaparin plus compression stockings is more effective in preventing venous thromboembolism than compression stockings alone. Venous thromboembolism occurs when a blood clot forms in large veins and travels to another part of the body. Researchers randomly assigned 307 surgical patients to receive either compression stockings alone or stockings plus enoxaparin, which is a form of low-molecular-weight heparin. The drug cut the risk of thromboembolism in half and did not increase the risk of bleeding.

Evaluation, Thromboembolism, Enoxaparin

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