title: [Long-term treatment with a low-molecular-weight heparin administered subcutaneously compared with a vitamin K antagonist: subanalysis of patients with cancer].
abstract: We performed a subanalysis of cancer patients enrolled in a clinical trial that compared long-term (6 months) treatment with a low-molecular-weight heparin (LMWH) administered subcutaneously or with acenocoumarol. The subanalysis assessed whether the characteristics of the tumor had an influence on the clinical response. A randomized open trial included 69 patients with cancer and symptomatic proximal deep vein thrombosis of the lower limbs. The tumor characteristics and treatment type were recorded. The main assessment criterion was the 12-month incidence of recurrent symptomatic venous thromboembolism (VTE). Sixty-one patients (88.4%) were analyzed. At the time of inclusion, the cancer characteristics and treatment were comparable between the 2 groups. Over the course of 12 months, the recurrent VTE was significantly greater in the elderly patients (71.5 ± 6.4 vs. 62.0 ± 15.1; p=.006). The logistic regression analysis showed no association between VTE recurrence and the location or extent of the tumor. However, the use of thrombogenic chemotherapy (p=.045) was independently associated with VTE recurrence, and longterm treatment with tinzaparin was almost a protective factor (p=.15). In this small sample, we observed an association between thrombogenic chemotherapy and recurrent VTE. The tendency towards a reduction in VTE recurrence at 12 months in patients with cancer in the LMWH group could be attributed to the effect of the full LMWH dosage.
authors.affiliation: Servicio de Angiología y Cirugía Vascular, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: aromera@bellvitgehospital.cat.
authors.forename: Antonio
authors.initials: A
authors.lastname: Romera-Villegas
authors.affiliation: Servicio de Angiología y Cirugía Vascular, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Martí Mestre
authors.affiliation: Servicio de Angiología y Cirugía Vascular, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Ramón
authors.initials: R
authors.lastname: Vila Coll
authors.affiliation: Laboratorios LEO Pharma S.A., Barcelona, España.
authors.forename: Esteve
authors.initials: E
authors.lastname: Colomé Nafría
mesh_terms: D000074:Acenocoumarol / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000074:Acenocoumarol
keywords: Antagonistas de la vitamina K; Cancer; Cáncer; Heparina de bajo peso molecular; Largo plazo; Long term; Low-molecular-weight heparin; Tromboembolia venosa; Venous thromboembolism; Vitamin K antagonists