Update on extended treatment for venous thromboembolism

Peñaloza-Martínez, Eduardo; Demelo‐Rodríguez, Pablo; Proietti, Marco; Fernández-Llamazares, Guillermo Soria; Llamazares-Mendo, Cristina; Walther, Luis Álvarez-Sala; Marra, Alberto M.; Toro‐Cervera, Jorge del

doi:10.1080/07853890.2018.1538564

Cited by 18 publications

(7 citation statements)

References 51 publications

(46 reference statements)

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“…A 3-month course of anticoagulation is adequate for patients with VTE provoked by major transient risk factors such as surgery or trauma because their risk of recurrence is only approximately 1% at 1 year and 3% at 5 years. 4 In contrast, extended anticoagulation is recommended for patients with unprovoked VTE and a low or moderate risk of bleeding, 3,6,7,36 because the risk of recurrence if anticoagulant therapy is stopped is approximately 10% at 1 year and 30% at 5 years. 37 In patients with a first unprovoked VTE and a high risk of bleeding, guidelines recommended stopping anticoagulation therapy at 3 months.…”

Section: Guideline Recommendations Regarding the Duration Of Anticoagmentioning

confidence: 99%

Broadening the Categories of Patients Eligible for Extended Venous Thromboembolism Treatment

Schindewolf

Weitz

2019

Thromb Haemost

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Traditionally, venous thromboembolism (VTE) resulting from major transient risk factors (e.g., surgery or trauma) or a major persistent risk factor such as cancer, has been defined as being provoked, whereas unprovoked VTE encompasses events without an identifiable cause. These categorizations influence anticoagulant treatment duration; unlike VTE provoked by major transient risk factors, extended anticoagulation beyond 3 months is advised for patients with cancer or unprovoked VTE due to risk persistence after treatment cessation. However, some patients with VTE provoked by minor transient or minor persistent risk factors may also be candidates for extended anticoagulation therapy due to the continuing risk of recurrence. In patients who require extended therapy, vitamin K antagonists (VKAs) are effective but are associated with an increased risk of bleeding and various treatment burdens (e.g., anticoagulation monitoring and dose adjustment). Evaluations of extended VTE treatment with the less-burdensome direct oral anticoagulants such as apixaban, dabigatran, edoxaban, and rivaroxaban show that they are at least as safe and effective as VKAs in a broad range of patients. In addition, apixaban and rivaroxaban offer more than one dosing option, allowing tailoring of treatment to the patient's specific risk factor profile. Analysis of more granular definitions for risk factor groupings has also yielded vital information on the most appropriate strategies for the treatment of patients with specific risk factors, highlighting that extended anticoagulation treatment may benefit those with minor transient and persistent environmental and nonenvironmental risk factors who commonly receive shorter-duration therapy.

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Section: Guideline Recommendations Regarding the Duration Of Anticoagmentioning

confidence: 99%

Broadening the Categories of Patients Eligible for Extended Venous Thromboembolism Treatment

Schindewolf

Weitz

2019

Thromb Haemost

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“…Venous thromboembolism (VTE) is the third most frequent cause of cardiovascular mortality. This condition mostly occurs in the presence of risk factors that can be acquired or congenital 1 . Deep vein thrombosis (DVT) has an incidence as low as 1 per 10,000 in younger patient groups whereas, in the general population, the incidence rate is 1 per 1000 2 .…”

Section: Introductionmentioning

confidence: 99%

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Jenab

Ghafouri

Hosseini

et al. 2022

Clinical Case Reports

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Bilateral proximal deep vein thrombosis (DVT) in the lower extremities of young patients should raise suspicion over pro-thrombotic conditions and venous anatomical abnormalities, even in the presence of other precipitating factors, such as viral infection. The authors present a 33-year-old man with bilateral DVT and absence of inferior vena cava (AIVC), who also had concurrent COVID-19, and discuss the management of this patient. K E Y W O R D Sabsence of inferior vena cava, anticoagulants, deep vein thrombosis, inferior vena cava agenesis, inferior vena cava atresia

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“…Blood hypercoagulability, circulatory stasis, and endothelial disruption are considered the pillars of the pathophysiology of VTE. Certain provoking factors (either persistent, e.g., cancer, or transient, e.g., recent surgery) increase the risk of VTE [1,5]. A strong association between cancer and VTE has already been established.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review

Galeano‐Valle

Ordieres‐Ortega

Oblitas

et al. 2021

IJMS

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The relationship between inflammation and venous thrombosis is not well understood. An inflammatory response may be both the cause and consequence of venous thromboembolism (VTE). In fact, several risk factors of VTE modulate thrombosis through inflammatory markers. Acute pulmonary embolism (PE) is burdened by a remarkable mortality rate, up to 34% in severely ill patients presenting with hemodynamic instability. Initial mortality risk stratification is based on hemodynamic instability. Patients with a situation of hemodynamic stability require immediate further risk assessment based on clinical, imaging, and circulating biomarkers, as well as the presence of comorbidities. Some inflammatory biomarkers have shown potential usefulness in the risk stratification of patients with VTE, especially acute PE. C-reactive protein on admission is associated with 30-day mortality and bleeding in VTE patients. P-selectin is associated with right ventricle dysfunction in PE patients and might be associated with VTE recurrences and the extension of thrombosis. Tissue factor microparticles are associated with VTE recurrence in cancer-associated thrombosis. Other inflammatory biomarkers present scarce evidence (inflammatory cytokines, erythrocyte sedimentation rate, fibrinogen, leukocyte count). In this manuscript, we will review the prognostic role of different inflammatory biomarkers available both for clinical practice and research in VTE patients.

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Update on extended treatment for venous thromboembolism

Cited by 18 publications

References 51 publications

Broadening the Categories of Patients Eligible for Extended Venous Thromboembolism Treatment

Broadening the Categories of Patients Eligible for Extended Venous Thromboembolism Treatment

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review

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