Unprovoked venous thromboembolism: Short term or indefinite anticoagulation? Balancing long-term risk and benefit

Blood Reviews
Marc A RodgerG Le Gal

Abstract

Whether to continue oral anticoagulant therapy indefinitely after completing 3 to 6 months of oral anticoagulant therapy for "unprovoked" venous thromboembolism (VTE), is one of the most important unanswered questions in VTE management. This long-term decision should be based on balancing the long-term mortality risk from recurrent VTE, largely preventable with oral anticoagulant therapy, against the long-term mortality risk of major bleeding, the principle complication of oral anticoagulant therapy. There exist important knowledge gaps in estimating the long-term mortality risk of recurrent VTE in patients with unprovoked VTE who discontinue therapy and the long-term mortality risk from major bleeding in those who continue oral anticoagulant therapy. These knowledge gaps, reviewed herein, are the source of uncertainty for patients and health care providers wrestling with this important question. One promising solution is recurrent VTE risk stratification where unprovoked VTE patients are categorised as low or high risk for recurrent VTE and clinical decision making is less ambiguous and ultimately will likely lead to better outcomes.

References

Jul 1, 1996·Annals of Internal Medicine·P PrandoniM H Prins
Feb 12, 1997·JAMA : the Journal of the American Medical Association·A LaupacisI G Stiell
Feb 18, 1998·JAMA : the Journal of the American Medical Association·J D DouketisJ S Ginsberg
Feb 24, 2001·The New England Journal of Medicine·P HariR S Lankipalli
Dec 18, 2002·Annals of Internal Medicine·Paolo PrandoniAntonio Girolami
Jun 20, 2003·Circulation·Richard H White
Jul 2, 2003·Annals of Internal Medicine·Giancarlo AgnelliUNKNOWN Warfarin Optimal Duration Italian Trial Investigators
Jul 11, 2003·The New England Journal of Medicine·Agnes Y Y LeeUNKNOWN Randomized Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Veno
Aug 15, 2003·The New England Journal of Medicine·Clive KearonUNKNOWN Extended Low-Intensity Anticoagulation for Thrombo-Embolism Investigators
Aug 28, 2003·JAMA : the Journal of the American Medical Association·Sabine EichingerPaul A Kyrle
Oct 31, 2003·The New England Journal of Medicine·Sam SchulmanUNKNOWN THRIVE III Investigators
Aug 11, 2005·JAMA : the Journal of the American Medical Association·David OstAlan Fein
Dec 20, 2005·Journal of Thrombosis and Haemostasis : JTH·M StainS Eichinger
Feb 8, 2006·Annals of Internal Medicine·Brendan M Reilly, Arthur T Evans
Feb 14, 2006·Journal of Thrombosis and Thrombolysis·Susan R Kahn
Jul 20, 2006·Journal of Thrombosis and Haemostasis : JTH·W AgenoA Venco
Jan 31, 2007·Annals of Internal Medicine·Jodi B SegalEric B Bass
Sep 26, 2007·Journal of Thrombosis and Haemostasis : JTH·T Baglin
Nov 24, 2007·Journal of Thrombosis and Haemostasis : JTH·C Kearon
Jul 10, 2008·Thrombosis and Haemostasis·Marc A RodgerMichael J Kovacs
Aug 30, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Marc A RodgerMichael J Kovacs

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Citations

Nov 6, 2012·The New England Journal of Medicine·Timothy A BrightonUNKNOWN ASPIRE Investigators
Jun 25, 2013·Blood Reviews·P L den ExterF A Klok
Apr 11, 2014·European Journal of Nuclear Medicine and Molecular Imaging·Pierre-Yves Le RouxPierre-Yves Salaun
Aug 5, 2015·Blood Reviews·David KeelingGrégoire Le Gal
Sep 11, 2012·Best Practice & Research. Clinical Haematology·Grégoire Le GalMarc Rodger
Nov 26, 2015·Thrombosis Research·Aurélien Delluc, Marc Carrier
Sep 27, 2013·Thrombosis and Haemostasis·Esteban GándaraMarc A Rodger
Jun 16, 2011·British Journal of Haematology·David KeelingUNKNOWN British Committee for Standards in Haematology
Nov 22, 2011·Thrombosis Research·Valérie OliéJoseph Emmerich
Jul 5, 2016·Lancet·Marcello Di NisioHarry R Büller
Jul 19, 2015·Phlebology·Christos KarathanosAthanasios D Giannoukas
Oct 27, 2015·Thrombosis Journal·Otto Moodley, Hadi Goubran
Oct 17, 2012·Geriatrics & Gerontology International·Reza AminiMehdi Rassafiani
Jul 1, 2015·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Philippe RobinPierre-Yves Salaun
Apr 28, 2017·International Journal of Laboratory Hematology·R K Pruthi

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