Anticoagulation Beyond 3 to 6Months: What Does the Data Tell Us?

Patients with a history of deep vein thrombosis and pulmonary embolism are at risk for a recurrent event. This is particularly true of patients with idiopathic events or events related to low risk triggers. In these patients extending anticoagulation beyond 3 to 6months may be warranted. Using clinical risk, biomarker analysis and risk stratification protocols we can make the best recommendations to patients with respect to the risks and benefits of ongoing therapy. Trials demonstrating benefit from low-dose aspirin for secondary prophylaxis may provide an option for patients in whom ongoing anticoagulation is deemed unsafe. In addition, recent introduction of the direct oral anticoagulants have expanded options for secondary prophylaxis for preventing venous thromboembolism recurrence.