Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jan-Dec:13:1753466619878556.
doi: 10.1177/1753466619878556.

Extended anticoagulation after venous thromboembolism: should it be done?

Caio J Fernandes  1   2   3 , Daniela Calderaro  4   5 , Bruna Piloto  4   5 , Susana Hoette  4 , Carlos Vianna Poyares Jardim  4   5 , Rogério Souza  4   5
Affiliations
Review

Extended anticoagulation after venous thromboembolism: should it be done?

Caio J Fernandes et al. Ther Adv Respir Dis. 2019 Jan-Dec.

Abstract

Most physicians understand venous thromboembolism (VTE) to be an acute and time-limited disease. However, pathophysiological and epidemiological data suggest that in most patients VTE recurrence risk is not resolved after the first 6 months of anticoagulation. Recurrence rates are high and potentially life-threatening. In these cases, it would make sense to prolong anticoagulation for an undetermined length of time. However, what about the bleeding rates, induced by prolonged anticoagulation? Would they not outweigh the benefit of reducing the VTE recurrent risk? How long should anticoagulation be continued, and should all patients suffering from VTE be provided with extended anticoagulation? This review will address the most recent data concerning extended anticoagulation in VTE secondary prophylaxis. The reviews of this paper are available via the supplementary material section.

Keywords: deep vein thrombosis; direct oral anticoagulants; extended anticoagulation; provoked; pulmonary embolism; treatment; unprovoked; venous thromboembolism.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: Caio J. Fernandes received lecture fees and participated in the advisory boards of Bayer, Boehringer-Ingelheim, and Daiichi-Sankyo. Daniela Calderaro received lecture fees and participated in the advisory boards of Bayer, Pfizer, and Daiichi-Sankyo. Bruna Piloto and Susana Hoette declare no conflict of interest. Carlos Vianna Poyares Jardim received lecture fees and participated in the advisory boards of Bayer and Boehringer-Ingelheim. Rogério Souza received lecture fees and participated in the advisory boards of Bayer, and Pfizer.

Figures

Figure 1.
Figure 1.
Summary of recommendations for extended anticoagulation after a first VTE event.
See this image and copyright information in PMC

References

    1. ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease burden. Thromb Haemost 2014; 112: 843–852. - PubMed
    1. Fernandes C, Jardim CVP, Alves JL, Jr, et al. Reperfusion in acute pulmonary thromboembolism. J Bras Pneumol 2018; 44: 180–181. - PMC - PubMed
    1. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet 1960; 1: 1309–1312. - PubMed
    1. Kernohan RJ, Todd C. Heparin therapy in thromboembolic disease. Lancet 1966; 1: 621–623. - PubMed
    1. Fernandes CJ, Luppino Assad AP, Alves-Jr JL, et al. Pulmonary embolism and gas exchange. Respiration 2019: 98: 253–262. - PubMed