Possibilities and results of using clopidogrel (Listab) in comprehensive treatment of patients with crural deep veins thrombosis

Gavrilenko A.V.^1,2, Voronov D.A.^1,2

1) Vascular Surgery Department, Russian Research Centre of Surgery named after Academician B.V. Petrovsky under the Russian Academy of Medical Sciences,
2) Chair of Cardiovascular Surgery No1 named after B.V. Petrovsky, Institute of Professional Education of the First Moscow State Medical University named after I.M. Sechenov, Moscow, Russia

The authors carried out a prospective non-randomized controlled study including patients undergoing conservative treatment for acute thrombosis of crural deep veins with a stable course of the disease. A total of 60 patients discharged from hospital for further outpatient follow up and treatment were subdivided into two groups: Group I (study group, "Listab" group) composed of 35 patients who immediately began taking prescribed clopidogrel ("Listab") at a dose of 75 mg a day, and Group II (first control group, "VKA" group) comprising 25 patients receiving vitamin K antagonists (VKA) at various doses according to the generally accepted recommendations.

We retrospectively formed Group III consisting of 21 patients (second control group, "ASA or VKA" group) who despite initial prescription of VKA either received them interruptedly and only for a short time after discharge from hospital or took preparations of acetylsalicylic acid (ASA) alone. The cumulative index of freedom from negative clinical outcomes after 12 months of follow up in the "Listab" group amounted to 0.9143, in the "VKA" group to 0.9600, and in the "ASA or VKA" group to 0.7619. The cumulative index of freedom from negative clinical and/or ultrasound outcomes after 12 months of follow up amounted to 0.8571, 0.8400, and 0.6190, respectively. In the "Listab" group the relative incidence of adverse events while taking the drug as calculated per 100 patient-months amounted to 1.79 and in the "VKA" group to 2.95. Administration of Listab was associated with the best patient compliance as compared to other drugs (VKA and ASA). The proportion of patients reporting regular taking of the drug in the "Listab" group amounted to 91.4%. A conclusion was drawn that in patients with crural deep vein thrombosis with a stable course of the acute period of the disease Listab may be used effectively and safely in comprehensive ambulatory treatment of patients having low adherence to taking VKA and to regular laboratory monitoring of the coagulation level (or if such monitoring is impossible), as well as in cases of high risk of haemorrhage while taking VKA. The final determination of the possibility of using clopidogrel-containing drugs and their place in treatment of the pathology concerned requires larger clinical trials.

KEY WORDS: crural deep vein thrombosis, conservative treatment, clopidogrel, Listab.

P. 98

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