E. Grau et al., Home treatment of deep venous thrombosis with low molecular weight heparin: Long-term incidence of recurrent venous thromboembolism, AM J HEMAT, 67(1), 2001, pp. 10-14
Outpatient treatment of deep venous thrombosis (DVT) with low molecular wei
ght heparin (LMWH) seems as safe and effective as inpatient treatment with
unfractionated heparin (UFH). However, most of the randomized trials compar
ing a LMWH with UFH described clinical outcomes within 3-6 months. The long
-term incidence of recurrent VTE after treatment of DVT with LMWH remains t
o be established. The primary objective of this retrospective study was to
document the long-term incidence of recurrent venous thromboembolism (VTE)
in patients with DVT treated with a LMWH, nadroparin in an outpatient basis
. The patients were evaluated 46 months after inclusion in two cohorts comp
aring home treatment with nadroparin (n = 130) with in-hospital treatment w
ith intravenous UFH (n = 149). More than 60% of the patients in the nadropa
rin group could be treated at home, either entirely or after a short stay i
n hospital. The age-adjusted thrombosis-free survival was not statistically
significant between nadroparin and UFH-treated patients (P = 0.084). There
was a nonsignificant trend favoring nadroparin as compared with UFH. The h
azard ratio (HR) for recurrent VTE in the nadroparin group with respect to
the UFH group was 0.44 (95% confidence interval, 0.17-1.12). No significant
differences were observed in overall mortality or major hemorrhage between
the two treatment groups. Our study suggests that home treatment of DVT wi
th LMWH is at least as effective and safe as in-hospital UFH after a long-t
erm follow-up period. Am. J. Hematol, 67:10-14, 2001. (C) 2001 Wiley-Liss,
Inc.