The Optimal Duration of Anticoagulation in Patients with Unprovoked Venous Thromboembolism

2016 ◽  
pp. 89-100
Author(s):  
Paolo Prandoni
Keyword(s):  
Venous Thromboembolism ◽  
Optimal Duration

scholarly journals Optimal Duration of Anticoagulation After Venous Thromboembolism

Circulation ◽  
2011 ◽  
Vol 123 (6) ◽  
pp. 664-667 ◽  
Author(s):  
Samuel Z. Goldhaber ◽  
Gregory Piazza
Keyword(s):  
Venous Thromboembolism ◽  
Optimal Duration

Extended Therapy for Primary and Secondary Prevention of Venous Thromboembolism

2010 ◽  
Vol 23 (4) ◽  
pp. 313-323 ◽  
Author(s):  
Susan E. Conway ◽  
Todd R. Marcy
Keyword(s):  
Health Care ◽  
Venous Thromboembolism ◽  
Secondary Prevention ◽  
Practice Guidelines ◽  
Anticoagulation Therapy ◽  
Patient Specific ◽  
First Episode ◽  
Care Providers ◽  
Primary And Secondary Prevention ◽  
Optimal Duration

Clinical practice guidelines currently suggest extended anticoagulation therapy for primary and secondary prevention of venous thromboembolism (VTE). The optimal duration of anticoagulation has been an active area of clinical investigation for patients undergoing orthopedic surgeries and those diagnosed with a first episode of unprovoked VTE. Practice guidelines, VTE incidence, clinical predictors/mediators, and clinical trial evidence is reviewed to help pharmacists and other health care providers make an informed, patient-specific decision on the optimal duration of anticoagulation therapy. Extended anticoagulation up to 5 weeks following orthopedic surgery for primary VTE prevention and indefinitely following a first episode of unprovoked VTE for secondary VTE prevention should be considered only if the risk of bleeding is not high and the cost and burden of anticoagulation is acceptable to the patient. The optimal duration of anticoagulation therapy for primary or secondary prevention of VTE should include the health care provider and patient making a decision based on evaluation of individual benefits, risks, and preferences.

Oral Anticoagulation after a First Episode of Venous Thromboembolism: How Long? How Strong?

1999 ◽  
Vol 82 (S 01) ◽  
pp. 124-126 ◽  
Author(s):  
H. H. Watzke
Keyword(s):  
Risk Factor ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Short Duration ◽  
Oral Anticoagulation ◽  
Thrombotic Event ◽  
First Episode ◽  
Optimal Duration ◽  
Optimal Intensity ◽  
Shed Light

SummaryA number of studies have been published in the last years which shed light on the optimal intensity and the optimal duration of oral anticoagulation in patients with venous thrombosis.Based on these studies it is now generally recommended to treat patients with venous thromboembolism at an INR ranging from 2.0 to 3.0. The optimal duration of anticoagulation mainly depends on the nature of the thrombotic event. In patients with a temporary prothrombotic risk factor such as surgery, immobilization or trauma a relatively short duration of oral anticoagulation (3-6 months) is generally recommended. Patients with idiopathic venous thromboembolism require a considerably longer duration of anticoagulation (6 months at least).

IDIOPATHIC VENOUS THROMBOEMBOLISM: RISK FACTORS OF RECURRENCE AND OPTIMAL DURATION OF ANTICOAGULANT THERAPY

2011 ◽  
Vol 22 ◽  
pp. S82-S83
Author(s):  
Pedro Ruiz-Artacho ◽  
Jose Maria Pedrajas-Navas ◽  
Angel Molino-Gonzalez ◽  
Vanesa Sendín-Martin ◽  
Nike Sanchez-Martinez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Optimal Duration

Venous Thromboembolism Prevention in Acutely Ill Nonsurgical Patients

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1318-1324 ◽  
Author(s):  
Donald F Brophy ◽  
John A Dougherty ◽  
James C Garrelts ◽  
Roy C Parish ◽  
Michael P Rivey ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Optimal Timing ◽  
Medical Patients ◽  
Prophylactic Regimen ◽  
Medline Search ◽  
Assessment Protocol ◽  
Mechanical Methods ◽  
Optimal Duration ◽  
Medical Inpatients

OBJECTIVE To review recent advances in the prevention of venous thromboembolism (VTE) in acutely ill nonsurgical inpatients. DATA SOURCES A MEDLINE search (1966–March 2005) was done to identify relevant articles relating to prevention of VTE in acutely ill nonsurgical inpatients. STUDY SELECTION AND DATA EXTRACTION Four major prophylaxis trials, one registry, one guideline, and supporting articles representative of the subject matter from the last few years were included. DATA SYNTHESIS Enoxaparin, dalteparin, fondaparinux, and unfractionated heparin 5000 units every 8 hours are effective in reducing the risk of VTE in acutely ill medical patients, but such prophylaxis is currently underused. Barriers to be overcome include recognition of the importance of VTE in this population, definition of the optimal strategy to assess risks, optimal timing of the risk assessment, optimal prophylactic regimen for a given level of risk or disease state, and optimal duration of prophylaxis. We recommend that acutely ill medical inpatients should be risk-stratified early in their hospitalization. At this time, the specific risk-assessment protocol should be derived from the trial(s) of the available formulary agent(s). Decisions about providing prophylaxis must also be made considering anticoagulant contraindications and renal function. Mechanical methods of prophylaxis should be considered as monotherapy only if an anticoagulant contraindication exists. The optimal duration of prophylaxis is not known, but 14 days was used in recent studies. CONCLUSIONS Prophylaxis of VTE in acutely ill medical inpatients is underused. Data provide some guidance for increasing awareness and optimizing patient care.

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