Document Detail


Early and short-term acenocumarine or dalteparin for the prevention of central vein catheter-related thrombosis in cancer patients: a randomized controlled study based on serial venographies.
MedLine Citation:
PMID:  19567452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We evaluated efficacy and safety of early and short-term prophylaxis with acenocumarine or dalteparin in the prevention of non-occlusive or occlusive central vein catheter-related thrombosis (CVCrT). PATIENTS AND METHODS: Consecutive cancer patients scheduled for chemotherapy randomly received: acenocumarine 1 mg/day for 3 days before and 8 days after central vein catheter (CVC) insertion; dalteparin 5000 IU 2 h before and daily for 8 days after CVC insertion; no anticoagulant treatment (NT). All patients underwent venography on days 8 and 30, some of them on days 90, 150 and 210 after CVC. RESULTS: A total of 450 patients were randomized, 348 underwent at least two venography. Both acenocumarine and dalteparin reduced venography-detected CVCrT rate [21.9% acenocumarine versus 52.6% NT, odds ratio (OR) 0.3, P < 0.01; 40% dalteparin versus 52.6% NT, OR 0.6, P = 0.05]. Acenocumarine was more effective than dalteparin (OR 0.4, P = 0.01). The rate of occlusive CVCrT was not different in the three groups (0.9% acenocumarine, 3.3% dalteparin, 1.8% NT; P = 0.40). Most CVCrTs (95.6%) were observed on day 8 after CVC insertion and were non-occlusive. CONCLUSIONS: In this study of early and short-term prophylaxis, acenocumarine was more effective than dalteparin on non-occlusive and asymptomatic CVCrT events. The first days following CVC insertion represent the highest risk for CVCrT.
Authors:
M De Cicco; M Matovic; L Balestreri; A Steffan; R Pacenzia; M Malafronte; D Fantin; C A Bertuzzi; F Fabiani; S Morassut; E Bidoli; A Veronesi
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-06-30
Journal Detail:
Title:  Annals of oncology : official journal of the European Society for Medical Oncology / ESMO     Volume:  20     ISSN:  1569-8041     ISO Abbreviation:  Ann. Oncol.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007735     Medline TA:  Ann Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1936-42     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, National Cancer Institute, Aviano (PN), Italy. mdecicco@cro.it
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MeSH Terms
Descriptor/Qualifier:
Acenocoumarol / administration & dosage,  therapeutic use*
Aged
Anticoagulants / administration & dosage,  therapeutic use*
Catheterization, Central Venous / adverse effects*
Dalteparin / administration & dosage,  therapeutic use*
Female
Humans
Male
Middle Aged
Neoplasms / complications,  therapy*
Phlebography*
Thrombosis / complications,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Dalteparin; 152-72-7/Acenocoumarol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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