New concepts in optimal management of anticoagulant therapy for extended treatment of venous thromboembolism

Sam Schulman; Mats Ögren

doi:10.1160/TH06-05-0235

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(03): 258-266
DOI: 10.1160/TH06-05-0235

Theme Issue Article

Schattauer GmbH

New concepts in optimal management of anticoagulant therapy for extended treatment of venous thromboembolism

Sam Schulman

¹Department of Medicine, McMaster University, Hamilton, Ontario, Canada, and Coagulation Unit, Department of Hematology, Karolinska University Hospital, Stockholm, Sweden

,

Mats Ögren

²Department of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden

› Author Affiliations

Abstract

Summary

Recent trials on secondary prophylaxis after venous thromboembolism (VTE) have provided a wealth of data on the risk factors for recurrence and, to some extent, also for bleeding. Some of the results are consistent across the studies, but there are also conflicting data. Certain risk factors, such as pulmonary embolism versus deep vein thrombosis or presence of cardiolipin antibodies, have a more pronounced influence on the risk early in the course of disease. Others, such as hereditary throm- bophilic defects, seem to gain importance over many years of follow-up. Therefore, it can be difficult to make decisions on an individual patient basis. In this article,data from important and illustrative trials have been extracted and compared and controversies highlighted. The conclusions drawn should help clinicians make balanced decisions on the optimal duration of anticoagulation after an episode of VTE.

Keywords

Venous thromboembolism - risk factors - recurrence - bleeding

Full Text

References

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