Residual vein thrombosis to establish duration of anticoagulation after a first episode of deep vein thrombosis: The Duration of Anticoagulation based on Compression Ultrasonography (DACUS) study

Alessandra Malato, Guido Bajardi, Alessandra Casuccio, Glauco Milio, Sergio Siragusa, Oreste Cormaci, Massimo Pellegrino, Guglielmo Mariani, Maria Giovanna Pellegrino, Raffaela Anastasio

Risultato della ricerca: Articlepeer review

140 Citazioni (Scopus)

Abstract

Residual vein thrombosis (RVT) indicates a prothrombotic state and is useful for evaluating the optimal duration of oral anticoagulant treatment (OAT). Patients with a first episode of deep vein thrombosis, treated with OAT for 3 months, were managed according to RVT findings. Those with RVT were randomized to either stop or continue anticoagulants for 9 additional months, whereas in those without RVT, OAT was stopped. Outcomes were recurrent venous thrombo-embolism and/or major bleeding. Residual thrombosis was detected in 180 (69.8%) of 258 patients; recurrent events occurred in 27.2% of those who discontinued (25/92; 15.2% person-years) and 19.3% of those who continued OAT (17/88; 10.1% person-years). The relative adjusted hazard ratio (HR) was 1.58 (95% confidence interval [CI], 0.85-2.93; P = .145). Of the 78 (30.2%) patients without RVT, only 1 (1.3%; 0.63% person-years) had a recurrence. The adjusted HR of patients with RVT versus those without was 24.9 (95% CI, 3.4-183.6; P = .002). One major bleeding event (1.1%; 0.53% person-years) occurred in patients who stopped and 2 occurred (2.3%; 1.1% person-years) in those who continued OAT. Absence of RVT identifies a group of patients at very low risk for recurrent thrombosis who can safely stop OAT. This trial was registered at http://www. ClinicalTrials.gov as no. NCT00438230
Lingua originaleEnglish
pagine (da-a)511-515
Numero di pagine6
RivistaBlood
Volume112
Stato di pubblicazionePublished - 2008

All Science Journal Classification (ASJC) codes

  • Hematology
  • Cell Biology
  • Biochemistry
  • Immunology

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