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|Title:||Optimal duration of anticoagulation in patients with unprovoked venous thromboembolism: the impact of novel anticoagulants||Authors:||Prandoni, Paolo
|Keywords:||Anticoagulants;Blood coagulation;Fibrin fragment D;Pulmonary embolism;Venous thromboembolism;Venous thrombosis||Keywords Plus:||DEEP-VEIN-THROMBOSIS;VITAMIN-K ANTAGONISTS;INTENSITY WARFARIN THERAPY;D-DIMER LEVELS;ORAL ANTICOAGULANTS;PULMONARY-EMBOLISM;LONG-TERM;1ST EPISODE;POSTTHROMBOTIC SYNDROME;RESIDUAL THROMBOSIS||Mesh headings:||Anticoagulants;Pulmonary Embolism;Venous Thromboembolism;Venous Thrombosis||Secondary Mesh headings:||Blood Coagulation;Drug Administration Schedule;Fibrin Fibrinogen Degradation Products;Hemorrhage;Humans;Randomized Controlled Trials as Topic;Risk Assessment;Risk Factors||Issue Date:||Oct-2017||Publisher:||EDIZIONI MINERVA MEDICA||Journal:||International angiology : a journal of the International Union of Angiology||Abstract:||
Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years approaches 50% of all patients with a first episode of unprovoked VTE. The persistence of residual vein thrombosis at ultrasound assessment has consistently been shown to increase the risk, as do persistently high values of D-dimer. Although the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, strategies that incorporate the assessment of residual vein thrombosis and D-dimer have the potential to identify a substantial proportion of subjects in whom anticoagulation can be safely discontinued. For those patients in whom anticoagulation cannot be discontinued, new opportunities are offered by the availability of low-dose anti-Xa compounds, which have been found to possess an extremely favourable benefit/risk profile.
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