TY - JOUR T1 - Tinzaparin and vitamin K antagonist (VKA) use in patients with cancer associated venous thromboembolism (VTE): A cohort study JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P2404 AU - Elise Noel-Savina AU - Olivier Sanchez AU - Renaud Descourt AU - Michel Andre AU - Guy Meyer AU - Christophe Leroyer AU - Francis Couturaud Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P2404.abstract N2 - Introduction:Low Molecular Weight Heparins are the mainstay of anticoagulation during the first 3 to 6 months of treatment of VTE in cancer patients. After 6 months,the optimal anticoagulant strategy remains uncertain.Objectives:The primary objective was to determine the risk of recurrent VTE and bleeding during and after 6 months of follow-up. Secondary objectives were to identify the risk factor.Methods:Multicenter retrospective cohort study (Jan 2004 to Mar 2011) including patients with cancer who received tinzaparin during at least 3 months for VTE. Outcomes were the recurrent VTE, bleeding and death.Results:250 patients were included. At 6 months, recurrent VTE occurred in 26 patients (10.4%, 22 on tinzaparin, 2 on VKA) and major bleeding in 14 patients (5.6% all on tinzaparin). Stopping anticoagulation in patients considered at low risk by physicians (i.e.; prior cancer surgery) was the only factor increased recurrent VTE (OR 7.2 95%CI, 2.0-25.7; p=0.002). After 6 months, recurrent VTE occurred in 20 patients (8%) and major bleeding in 4 patients (1.6%). Stopping anticoagulation in relation with major bleeding or metastatic cancer increased risk of recurrent VTE (OR 2.3, 95%CI, 0.9-5.4; p=0.07; and OR 1.8 95%CI, 1.0-3.3; p=0.07; respectively). No factor increased the risk of major bleeding.The overall mortality was 42.8%.Conclusions:During the first 6 months, the recurrent VTE was related to early discontinuation of anticoagulation in patients considered at low risk of recurrence by physicians. After 6 month, the risks of recurrent VTE were similar with either VKA or tinzaparin and were mainly related to metastatic cancer and major bleeding. ER -