Optimal Duration of Anticoagulation After Venous Thromboembolism: Fixed and Evidence-Based, or Flexible and Personalized?
Authors: Samuel Z. Goldhaber
Journal: Annals of Internal Medicine (2009)

Editorials5 May 2009Optimal Duration of Anticoagulation After Venous Thromboembolism: Fixed and Evidence-Based, or Flexible and Personalized?Samuel Z. Goldhaber, MDSamuel Z. Goldhaber, MDFrom Brigham and Women's Hospital, Boston, MA 02115.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-9-200905050-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Optimal management of acute venous thromboembolism (VTE) requires institution of rapidly effective and safe anticoagulation. Much clinical investigation has focused on developing convenient and reliable anticoagulation regimens that use parenteral low-molecular-weight heparin or fondaparinux as a "bridge" to oral anticoagulant therapy with warfarin. Many novel oral anticoagulant therapies, administered in fixed doses without routine coagulation monitoring, are in advanced development and have the potential for eventual approval as monotherapy for pulmonary embolism or deep venous thrombosis (DVT).Although everyone agrees that anticoagulation is the foundation of treatment of VTE, the optimal duration of therapy is hotly debated. Unlike other areas ...References1. Prandoni P, Lensing AW, Cogo A, Cuppini S, Villalta S, Carta M, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med. 1996;125:1-7. [PMID: 8644983] LinkGoogle Scholar2. Prandoni P, Prins MH, Lensing AW, Ghirarduzzi A, Ageno W, Imberti D, et al. Residual thrombosis on ultrasonography to guide the duration of anticoagulation in patients with deep venous thrombosis. A randomized trial. Ann Intern Med. 2009;150:577-585. LinkGoogle Scholar3. Cook NR, Buring JE, Ridker PM. The effect of including C-reactive protein in cardiovascular risk prediction models for women. Ann Intern Med. 2006;145:21-9. [PMID: 16818925] LinkGoogle Scholar4. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ; American College of Chest Physicians. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:454S-545S. [PMID: 18574272] CrossrefMedlineGoogle Scholar5. Ridker PM, Goldhaber SZ, Danielson E, Rosenberg Y, Eby CS, Deitcher SR; PREVENT Investigators. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med. 2003;348:1425-34. [PMID: 12601075] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital, Boston, MA 02115.Disclosures: None disclosed.Corresponding Author: Samuel Z. Goldhaber, MD, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResidual Thrombosis on Ultrasonography to Guide the Duration of Anticoagulation in Patients With Deep Venous Thrombosis Paolo Prandoni , Martin H. Prins , Anthonie W.A. Lensing , Angelo Ghirarduzzi , Walter Ageno , Davide Imberti , Gianluigi Scannapieco , Giovanni B. Ambrosio , Raffaele Pesavento , Stefano Cuppini , Roberto Quintavalla , Giancarlo Agnelli , and Is Lifelong Anticoagulation Worth the Risk in Patients With Unprovoked DVT? Ferdinando Cortese Is Lifelong Anticoagulation Worth the Risk in Patients With Unprovoked DVT? Samuel Z. Goldhaber Metrics Cited byVerhältnis von personalisierter zu evidenzbasierter MedizinCORRELATION OF PULMONARY EMBOLISM SEVERITY INDEX AND PULMONARY ARTERY INVOLVEMENT IN CT PULMONARY ANGIOGRAM- EXPERIENCE IN A TERTIARY CARE CENTREPersonalized medicine: a competitor or an upgrade of evidence-based medicine?Pulmonary EmbolismPatient-Level Meta-analysis: Effect of Measurement Timing, Threshold, and Patient Age on Ability of d-Dimer Testing to Assess Recurrence Risk After Unprovoked Venous ThromboembolismJames Douketis, MD, Alberto Tosetto, MD, Maura Marcucci, MD, Trevor Baglin, MD, PhD, Mary Cushman, MD, MSc, Sabine Eichinger, MD, Gualtiero Palareti, MD, PhD, Daniela Poli, MD, R. Campbell Tait, MBChB, and Alfonso Iorio, MDRisk Factors for Venous ThromboembolismIs Lifelong Anticoagulation Worth the Risk in Patients With Unprovoked DVT?Ferdinando Cortese, MD 5 May 2009Volume 150, Issue 9Page: 644-646KeywordsAnticoagulant therapyCancer treatmentClinical geneticsMedical risk factorsPrecision medicinePulmonary embolismThrombosisUltrasound imagingVeinsVenous thromboembolism ePublished: 5 May 2009 Issue Published: 5 May 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...