Titre
Vitamin K Antagonists After 6 Months of Low-Molecular-Weight Heparin in Cancer Patients with Venous Thromboembolism.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Chai-Adisaksopha, C.
Auteure/Auteur
Iorio, A.
Auteure/Auteur
Crowther, M.A.
Auteure/Auteur
de Miguel, J.
Auteure/Auteur
Salgado, E.
Auteure/Auteur
Zdraveska, M.
Auteure/Auteur
Fernández-Capitán, C.
Auteure/Auteur
Nieto, J.A.
Auteure/Auteur
Barillari, G.
Auteure/Auteur
Bertoletti, L.
Auteure/Auteur
Monreal, M.
Auteure/Auteur
Contributrices/contributeurs
Aibar, M.A.
Arcelus, J.I.
Ballaz, A.
Barba, R.
Barrón, M.
Barrón-Andrés, B.
Bascuñana, J.
Blanco-Molina, A.
Bueso, T.
Calvo, B.
Cañada, G.
Cañas, I.
Casado, I.
Culla, A.
de Miguel, J.
Del Toro, J.
Díaz-Peromingo, J.A.
Falgá, C.
Fernández-Capitán, C.
Font, C.
Font, L.
Gallego, P.
García-Bragado, F.
Gómez, V.
González, J.
Grau, E.
Guil, M.
Guirado, L.
Gutiérrez, J.
Hernández, G.
Hernández-Blasco, L.
Isern, V.
Jara-Palomares, L.
Jaras, M.J.
Jiménez, D.
Lacruz, B.
Lecumberri, R.
Lobo, J.L.
López-Jiménez, L.
López-Reyes, R.
López-Sáez, J.B.
Lorente, M.A.
Lorenzo, A.
Madridano, O.
Maestre, A.
Manrique-Abos, I.
Marchena, P.J.
Martín-Antorán, J.M.
Martín-Martos, F.
Monreal, M.
Morales, M.V.
Morillo, R.
Nauffal, D.
Nieto, J.A.
Nieto, S.
Núñez, M.J.
Odriozola, M.
Otalora, S.
Otero, R.
Pagán, B.
Pedrajas, J.M.
Pérez, C.
Peris, M.L.
Pons, I.
Porras, J.A.
Ramirez, L.
Riera, A.
Rivas, A.
Rodríguez, C.
Rodríguez-Dávila, M.A.
Rosa, V.
Ruiz-Giménez, N.
Sampériz, A.
Sánchez, R.
Sala, M.C.
Sahuquillo, J.C.
Sanz, O.
Soler, S.
Suárez-González, I.
Suriñach, J.M.
Tiberio, G.
Tolosa, C.
Trujillo-Santos, J.
Uresandi, F.
Valero, B.
Valle, R.
Vela, J.
Vicente, M.P.
Vidal, G.
Vilella-Tomás, V.
Villalta, J.
Malfante, P.C.
Vanassche, T.
Verhamme, P.
Wells, P.
Hirmerova, J.
Malý, R.
Tomko, T.
Celis, G.
Salgado, E.
Sánchez, G.T.
Bertoletti, L.
Bura-Riviere, A.
Farge-Bancel, D.
Hij, A.
Mahé, I.
Merah, A.
Quere, I.
Papadakis, M.
Braester, A.
Brenner, B.
Tzoran, I.
Apollonio, A.
Barillari, G.
Bertone, A.
Bilora, F.
Bucherini, E.
Candelero, G.
Ciammaichella, M.
Di Micco, P.
Ferrazzi, P.
Grandone, E.
Lessiani, G.
Lodigiani, C.
Mastroiacovo, D.
Pace, F.
Pesavento, R.
Pinelli, M.
Prandoni, P.
Rosa, M.
Rota, L.
Tiraferri, E.
Tonello, D.
Tufano, A.
Venturelli, U.
Visonà, A.
Zalunardo, B.
Drucka, E.
Kigitovica, D.
Skride, A.
Sousa, M.S.
Bosevski, M.
Zdraveska, M.
Bounameaux, H.
Mazzolai, L.
Serrano, J.C.
Groupes de travail
RIETE investigators
Liens vers les personnes
Liens vers les unités
ISSN
1555-7162
Statut éditorial
Publié
Date de publication
2018-04
Volume
131
Numéro
4
Première page
430
Dernière page/numéro d’article
437
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Low-molecular-weight heparin (LMWH) is the treatment of choice in cancer patients with venous thromboembolism. However, data on continuing LMWH treatment beyond 6 months remain scanty.
We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to compare the rate of venous thromboembolism recurrences and major bleeding appearing beyond the first 6 months of anticoagulant therapy in cancer patients with venous thromboembolism, according to therapy with LMWH or vitamin K antagonists (VKA). We performed a propensity score-matched cohort study.
After propensity matching, 482 cancer patients continued to receive LMWH and 482 switched to VKA. During the course of anticoagulant therapy (mean 275.5 days), 57 patients developed venous thrombosis recurrences (recurrent pulmonary embolism 26, recurrent deep vein thrombosis 29, both 2), 28 had major bleeding, 38 had nonmajor bleeding, and 129 died. No patient died of recurrent venous thrombosis, and 5 patients died of bleeding (2 were on LMWH, 3 on VKA). Patients who continued with LMWH had a similar rate of deep vein thrombosis recurrences (relative risk [RR] 1.41; 95% confidence interval [CI], 0.68-2.93), pulmonary embolism recurrences (RR 0.73; 95% CI, 0.34-1.58), major bleeding (RR 0.96; 95% CI, 0.51-1.79), or nonmajor bleeding (RR 1.15; 95% CI, 0.55-2.40), compared with those who switched to VKA, but a higher mortality rate (RR 1.58; 95% CI, 1.13-2.20).
In cancer patients with venous thromboembolism who completed 6 months of LMWH therapy, switching to VKA was associated with a similar risk of venous thrombosis recurrences or bleeding when compared with patients who continued LMWH.
We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to compare the rate of venous thromboembolism recurrences and major bleeding appearing beyond the first 6 months of anticoagulant therapy in cancer patients with venous thromboembolism, according to therapy with LMWH or vitamin K antagonists (VKA). We performed a propensity score-matched cohort study.
After propensity matching, 482 cancer patients continued to receive LMWH and 482 switched to VKA. During the course of anticoagulant therapy (mean 275.5 days), 57 patients developed venous thrombosis recurrences (recurrent pulmonary embolism 26, recurrent deep vein thrombosis 29, both 2), 28 had major bleeding, 38 had nonmajor bleeding, and 129 died. No patient died of recurrent venous thrombosis, and 5 patients died of bleeding (2 were on LMWH, 3 on VKA). Patients who continued with LMWH had a similar rate of deep vein thrombosis recurrences (relative risk [RR] 1.41; 95% confidence interval [CI], 0.68-2.93), pulmonary embolism recurrences (RR 0.73; 95% CI, 0.34-1.58), major bleeding (RR 0.96; 95% CI, 0.51-1.79), or nonmajor bleeding (RR 1.15; 95% CI, 0.55-2.40), compared with those who switched to VKA, but a higher mortality rate (RR 1.58; 95% CI, 1.13-2.20).
In cancer patients with venous thromboembolism who completed 6 months of LMWH therapy, switching to VKA was associated with a similar risk of venous thrombosis recurrences or bleeding when compared with patients who continued LMWH.
PID Serval
serval:BIB_2966AF5192BA
PMID
Date de création
2018-10-12T12:17:59.709Z
Date de création dans IRIS
2025-05-20T17:22:52Z