Document Detail


Unprovoked venous thromboembolism: Short term or indefinite anticoagulation? Balancing long-term risk and benefit.
MedLine Citation:
PMID:  20633967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M Rodger; M Carrier; E Gandara; G Le Gal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-07-14
Journal Detail:
Title:  Blood reviews     Volume:  24     ISSN:  1532-1681     ISO Abbreviation:  Blood Rev.     Publication Date:    2010 Jul-Sep
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708558     Medline TA:  Blood Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  171-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Thrombosis Program, Division of Hematology, Department of Medicine, University of Ottawa, Ottawa Hospital, General Campus, Ottawa, ONT, Canada. mrodger@ohri.ca
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / administration & dosage*,  adverse effects*
Heparin, Low-Molecular-Weight / administration & dosage,  adverse effects
Humans
Risk Factors
Treatment Outcome
Venous Thromboembolism / drug therapy*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Heparin, Low-Molecular-Weight

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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