2012/06/26 by Paulien G. de Jong, Michiel Coppens, Saskia Middeldorp · 2 citations
Medicine · #Venous Thromboembolism Diagnosis and Management #Atrial Fibrillation Management and Outcomes #Blood Coagulation and Thrombosis Mechanisms #Medicine #Anticoagulant therapy #Venous thromboembolism #Anticoagulant #Intensive care medicine #Risk factor #Surgery #Internal medicine #Thrombosis
paper · pdf · doi:10.1111/j.1365-2141.2012.09196.x
openalex publication_date 2012/06/26 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Venous thromboembolism (VTE) is effectively treated with anticoagulant therapy. After an initial treatment phase, extended treatment is effective to prevent recurrence after a first event but this is at the expense of a continued risk of bleeding. Ideally, patients at a high risk of recurrence and low risk of bleeding continue anticoagulant therapy, and for those at low risk of recurrence the duration of treatment can be limited. Identifying these patients, however, is difficult. Duration of treatment after a first VTE provoked by a transient risk factor should be limited to 3 months. Although guidelines suggest extended treatment for all patients after unprovoked VTE unless bleeding risk is high, we emphasize that the long-term risks of recurrent VTE off anticoagulation are uncertain whereas the risk of bleeding associated with anticoagulant therapy increases with age. In the absence of evidence of replaced mortality or improved quality of life with extended anticoagulant treatment, we suggest a limited duration for most patients after a first VTE. Extended treatment can be considered, based mainly on patient preference.