A 6-month venographic follow-up in 164 patients with acute deep vein thrombosis.
A total of 164 patients were recruited from a randomized trial comparing a low molecular weight heparin, dalteparin, given subcutaneously once daily with a continuous intravenous infusion of unfractionated heparin in the initial treatment of acute deep vein thrombosis. The primary objective of this follow-up study was to investigate whether there were any differences between the two treatment groups with respect to Marder score changes 6 months after the initial diagnosis using repeated venography. The secondary objectives were to analyse whether certain haemostatic and acute phase parameters or patient characteristics influenced the venographic outcome.


RESULTS
Complete lysis of the thrombus was observed in 38.4% of the patients and a partial lysis in another 54.3% assessed by venography 6 months after the acute event. Extension of the thrombus was seen in 7.3% of the patients. There were no significant differences in the change in mean Marder score before treatment and at the 6 month follow-up between the two treatment groups, irrespective of thrombus localisation. In a regression model, male gender, low levels of orosomucoid and increased levels of d-dimer in plasma on day 5 were independently associated (p <0.05) with an enhanced absolute resolution of the thrombus at 6 months. No differences in symptoms and signs in the thrombotic leg at follow-up, comparing the treatment given, or thrombus extension at diagnosis and 6 months later, were demonstrated.


CONCLUSIONS
Dalteparin given once daily subcutaneously was as effective as continuous intravenous infusion of unfractionated heparin in the initial treatment of deep vein thrombosis assessed by Marder score evaluation 6 months after the acute event.
Holmström
M
M
Department of Haematology, Huddinge Hospital, Stockholm, Sweden.
Lindmarker
P
P
Granqvist
S
S
Johnsson
H
H
Lockner
D
D
D000208:Acute Disease; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D017985:Dalteparin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage*; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D013924:Thrombophlebitis / Q000188:drug therapy / Q000503:physiopathology*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin; D017985:Dalteparin