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Cancer patients who receive central venous catheters (CVCs) for chemotherapy are at risk for venous thromboembolism and often are treated with prophylactic warfarin, although the evidence supporting this practice is now more than a decade old. Results from recent trials, in which more-modern, apparently less-thrombogenic, CVCs were used, suggest that anticoagulation is no longer warranted.
Researchers randomized 812 patients with cancer who received CVCs for chemotherapy; half received daily warfarin (1-mg fixed dose or dose adjusted to maintain INR between 1.5 and 2.0), and half did not receive warfarin. Another 778 patients, whose physicians were unwilling to permit their assignment to a no-warfarin arm, were randomized to either fixed-dos…