Long-term management of patients after venous thromboembolism

Circulation
Clive Kearon

Abstract

Long-term treatment of venous thromboembolism (VTE) focuses mainly on the duration of anticoagulant therapy, usually with vitamin K (VK) antagonists. The duration of therapy should be individualized based on the risk of recurrent VTE if treatment were stopped and the risk of bleeding if treatment were continued. The risk of recurrence is low if thrombosis was provoked by a major reversible risk factor such as surgery; 3 months of treatment is usually adequate for such patients. The risk of recurrence is high if thrombosis was unprovoked ("idiopathic") or associated with an irreversible risk factor such as cancer; anticoagulant treatment for at least 6 months, and often indefinitely, is indicated for such patients. Risk of recurrence is intermediate if thrombosis was associated with a minor transient risk factor; such patients can be treated for 3 to 6 months. Within each of these categories, presentation as pulmonary embolism, >1 previous VTE, an underlying malignancy, an antiphospholipid antibody, or selected hereditary thrombophilic states favor more prolonged therapy, whereas isolated distal deep vein thrombosis, high risk of bleeding, and patient preference favor shorter treatment. The optimal intensity of anticoagulant the...Continue Reading

References

Oct 18, 1979·The New England Journal of Medicine·R HullP Armstrong
Oct 15, 1992·The New England Journal of Medicine·P PrandoniJ W ten Cate
Dec 30, 1982·The New England Journal of Medicine·R HullP Ockelford
Jan 28, 1982·The New England Journal of Medicine·R HullD McLaughlin
Jun 1, 1994·Annals of Internal Medicine·E M Hylek, D E Singer
Sep 1, 1993·The American Journal of Medicine·C S Landefeld, R J Beyth
Jul 1, 1996·Annals of Internal Medicine·P PrandoniM H Prins
Feb 18, 1998·JAMA : the Journal of the American Medical Association·J D DouketisJ S Ginsberg
Jul 21, 1998·Annals of Internal Medicine·M MargaglioneG Di Minno
Mar 13, 1999·Archives of Internal Medicine·P M KuijerH R Büller
Apr 21, 1999·Lancet·F R Rosendaal
Nov 24, 1999·The American Journal of Medicine·R H WhiteP S Romano
Dec 11, 1999·JAMA : the Journal of the American Medical Association·S S Anand, S Yusuf
Apr 25, 2000·Annual Review of Medicine·C KearonJ Hirsh
Aug 19, 2000·The New England Journal of Medicine·P A KyrleS Eichinger
Jan 12, 2001·Journal of the American College of Cardiology·J S MilesP M Ridker
Jul 21, 2001·The New England Journal of Medicine·G AgnelliUNKNOWN Warfarin Optimal Duration Italian Trial Investigators
Sep 8, 2001·The New England Journal of Medicine·C M Bell, D A Redelmeier
Jan 17, 2002·The New England Journal of Medicine·P F FedulloL J Rubin

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Citations

Jun 6, 2007·Journal of Thrombosis and Thrombolysis·Mirjana KovacIvo Elezovic
Oct 18, 2007·Journal of Thrombosis and Thrombolysis·Amir K Jaffer
Mar 28, 2013·Journal of Thrombosis and Thrombolysis·Tracy Minichiello, David Garcia
Mar 16, 2007·Journal of General Internal Medicine·Cary P GrossHarlan M Krumholz
Aug 6, 2013·Indian Journal of Pediatrics·Ayesha N Zia, Meera Chitlur
Aug 24, 2006·Current Opinion in Pulmonary Medicine·Susan R Kahn
May 22, 2009·Current Opinion in Pulmonary Medicine·Richard H White, Susan Murin
Apr 4, 2006·Current Opinion in Rheumatology·Doruk Erkan, Michael D Lockshin
Sep 20, 2007·Internal Medicine·Yoshiomi ShimizuTakenori Yamaguchi
Jan 25, 2011·Expert Opinion on Pharmacotherapy·Javier Trujillo-Santos, Manuel Monreal
Apr 12, 2014·Clinics in Geriatric Medicine·Susan M Friedman, Joshua D Uy
Mar 30, 2010·Journal of Thrombosis and Haemostasis : JTH·J A NietoUNKNOWN Riete Investigators
May 15, 2010·Thrombosis Research·Javier Trujillo-SantosUNKNOWN RIETE Investigators
Sep 8, 2009·Progress in Cardiovascular Diseases·Diane George, Doruk Erkan
Mar 17, 2009·Best Practice & Research. Clinical Haematology·Manuel Monreal, Javier Trujillo-Santos
Apr 15, 2008·Cardiology Clinics·Huyen TranJeffrey Ginsberg
May 6, 2008·Pathologie-biologie·P MismettiN Moulin
Apr 1, 2008·Journal of Vascular and Interventional Radiology : JVIR·Sanjiv ParikhAnthony Comerota
Dec 27, 2005·Clinics in Geriatric Medicine·Huyen TranJeffrey Ginsberg
Sep 12, 2006·Obstetrics and Gynecology Clinics of North America·Michiel CoppensSaskia Middeldorp
May 8, 2009·The Mount Sinai Journal of Medicine, New York·Richard H White, Robert C Gosselin
May 12, 2006·The American Heart Hospital Journal·Jeffrey I Weitz
Jul 11, 2006·British Journal of Haematology·Susan R Kahn
Jan 23, 2008·Journal of Thrombosis and Haemostasis : JTH·R BarbaUNKNOWN Riete Investigators
Jul 15, 2006·Journal of Thrombosis and Haemostasis : JTH·M M C HovensM V Huisman
Jun 4, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Graeme J HankeyThorsten Steiner
Jan 24, 2014·Journal of Thrombosis and Haemostasis : JTH·J-P GalanaudUNKNOWN OPTIMEV-SFMV investigators
Dec 13, 2012·IEEE Transactions on Medical Imaging·Cédric SchmittGuy Cloutier
Jun 1, 2005·The American Journal of Medicine·Drahomir AujeskyMark S Roberts
May 26, 2009·Journal of Vascular and Interventional Radiology : JVIR·John A KaufmanAnthony Venbrux
Sep 6, 2006·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Wendy L Marr
Aug 2, 2006·Thrombosis Research·Matthew T RondinaGeorge M Rodgers
Apr 26, 2006·International Journal of Cardiology·Sandra OhlenforstBernd Pötzsch
Dec 20, 2005·Seminars in Oncology Nursing·Carolyn Grande, Millie Caparro
Sep 16, 2015·Thrombosis Research·Anastazja SzlauerAnetta Undas
Apr 24, 2016·The Veterinary Journal·Unity JefferyDana LeVine
Jun 24, 2008·American Journal of Obstetrics and Gynecology·Christina M Scifres, George A Macones
Feb 17, 2009·Thrombosis Research·Javier Trujillo-SantosUNKNOWN RIETE Investigators
Oct 21, 2016·Nutrition Journal·Maria Luisa FonteHellas Cena
Jun 3, 2016·Journal of Cardiovascular Pharmacology and Therapeutics·Lee Joseph, John R Bartholomew
Jul 7, 2017·Gerontology & Geriatric Medicine·Jung-Ah LeeAlpesh N Amin

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