Duration of warfarin for new DVT

By  |  May 4, 2009 | 

Duration of warfarin for first DVT is hotly debated. In this multi-center trial of patients with new first DVT, patients were randomized to fixed-duration or flexible-duration (based on consecutive USG findings at 3 months). The fixed-group received 3 months of warfarin for secondary DVT, and 6 months for unprovoked DVT. The flexible-group received 3 months (if their 3 month USG showed vein re-canalization). For those not re-canalized at 3 months, they received additional USG at 3 and 9 months (for secondary DVT) and at 3, 9, 15, and 21 months (for unprovoked DVT). The 33 month f/u recurrent DVT risk was 12% in the flexible-group, which was significantly lower than the 17% in the fixed group. This indicates an advantage of continuing warfarin in patients without re-canalization. However, an editorialist points out that patients with idiopathic DVT need indefinite warfarin, and those with provoked DVT need “time-limited” warfarin. The latter may be a reasonable group to schedule f/u USG to determine length of warfarin treatment (abstract).

About the Author:

Danielle Scheurer
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

Categories

Related Posts

By  | July 2, 2015 |  0
I am coming up on my two year anniversary. Not my wedding anniversary (soon to be 15 years – thanks Maia!), but two years since I joined the ranks of the patients. It was two years ago this week that my day was interrupted by a page from my internist saying, “I don’t know how […]
By  | September 8, 2014 |  3
  As you can see, no glamour shots for this month’s post. I knew it would come at some point, and my first hospitalization related to my CLL came in a big way in mid-July. Given my interest in global health, it was only fitting that I managed to get sick while out of the […]
By  | July 6, 2013 |  0
This large multicenter trial randomized patients with acute VTE to apixaban (10mg BID for 1 week, followed by 5mg BID for 6 months) versus conventional therapy (lovenox-warfarin). The primary outcome was similar between groups (symptomatic VTE or death related to VTE), but major and minor bleeding occurred significantly less often with apixaban. Apixaban is a […]

Leave A Comment