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Extended anticoagulation after venous thromboembolism: should it be done?
Caio J Fernandes1,2,3, Daniela Calderaro4,5, Bruna Piloto4,5
1Cardiopulmonary Department, Heart Institute, University of Sao Paulo Medical School, 44, Av. Dr. Eneas de Carvalho Aguiar, Sao Paulo, 05403-000, Brazil.
Therapeutic Advances in Respiratory Disease
|September 28, 2019
Summary
Extended anticoagulation for venous thromboembolism (VTE) may reduce recurrence risk, but bleeding risks must be weighed. This review examines current data on long-term anticoagulation for VTE secondary prevention.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Physicians often perceive venous thromboembolism (VTE) as an acute, self-limiting condition.
- Emerging data indicate that VTE recurrence risk persists beyond initial anticoagulation, posing significant health threats.
- The necessity and safety of prolonged anticoagulation for VTE secondary prophylaxis are under scrutiny.
Purpose of the Study:
- To review current evidence on extended anticoagulation for VTE secondary prophylaxis.
- To evaluate the balance between VTE recurrence reduction and bleeding risk with prolonged anticoagulation.
- To inform clinical decision-making regarding the duration of anticoagulation in VTE patients.
Main Methods:
- Systematic review of recent pathophysiological and epidemiological data.
- Analysis of studies investigating extended anticoagulation strategies for VTE.
- Evaluation of recurrence rates and bleeding complications associated with prolonged anticoagulation.
Main Results:
- VTE recurrence rates remain substantial after the initial 6 months of anticoagulation.
- Prolonged anticoagulation demonstrates potential in reducing VTE recurrence.
- Bleeding risks associated with extended anticoagulation require careful consideration and patient selection.
Conclusions:
- Extended anticoagulation is a viable strategy for secondary VTE prevention in select patients.
- Individualized risk-benefit assessment is crucial for determining the optimal duration of anticoagulation.
- Further research is needed to refine guidelines for long-term anticoagulation in VTE management.
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