Extended-Duration Venous Thromboembolism Prophylaxis for Medical Patients
Authors: Russell D. Hull
Journal: Annals of Internal Medicine (2010)

Letters16 November 2010Extended-Duration Venous Thromboembolism Prophylaxis for Medical PatientsRussell D. Hull, MBBS, and the EXCLAIM Steering CommitteeRussell D. Hull, MBBSFrom University of Calgary, Foothills Hospital, Calgary, Alberta T2N 2T9, Canada.Search for more papers by this author, and the EXCLAIM Steering CommitteeSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-10-201011160-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Dentali and colleagues for highlighting bleeding risk as a key factor in the decision to provide extended-duration anticoagulant prophylaxis. Stratification of patients according to bleeding risk would enable clinicians to clearly identify patients who are more likely to have hemorrhagic complications. Because few major bleeding events occurred in the study (n = 35), we cannot accurately develop a predictive model. The EXCLAIM study demonstrated an increased risk for bleeding events in patients who received antiplatelet therapy. This population also had higher VTE event rates than did patients who did not receive antiplatelet therapy (31 of 324 ...References1. Samama MM, Cohen AT, Darmon JY, Desjardins L, Eldor A, Janbon C, et al. A comparison of enoxaparin with placebo for the prevention of venous thromboembolism in acutely ill medical patients. Prophylaxis in Medical Patients with Enoxaparin Study Group. N Engl J Med. 1999;341:793-800. [PMID: 10477777] CrossrefMedlineGoogle Scholar2. Cohen AT, Davidson BL, Gallus AS, Lassen MR, Prins MH, Tomkowski W, et al; ARTEMIS Investigators. Efficacy and safety of fondaparinux for the prevention of venous thromboembolism in older acute medical patients: randomised placebo controlled trial. BMJ. 2006;332:325-9. [PMID: 16439370] CrossrefMedlineGoogle Scholar3. Leizorovicz A, Cohen AT, Turpie AG, Olsson CG, Vaitkus PT, Goldhaber SZ; PREVENT Medical Thromboprophylaxis Study Group. Randomized, placebo-controlled trial of dalteparin for the prevention of venous thromboembolism in acutely ill medical patients. Circulation. 2004;110:874-9. [PMID: 15289368] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Calgary, Foothills Hospital, Calgary, Alberta T2N 2T9, Canada.Disclosures: Disclosures for the authors of the EXCLAIM study can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M09-0393. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExtended-Duration Venous Thromboembolism Prophylaxis in Acutely Ill Medical Patients With Recently Reduced Mobility Russell D. Hull , Sebastian M. Schellong , Victor F. Tapson , Manuel Monreal , Meyer-Michel Samama , Philippe Nicol , Eric Vicaut , Alexander G.G. Turpie , Roger D. Yusen , and Extended-Duration Venous Thromboembolism Prophylaxis for Medical Patients Francesco Dentali , Monica Gianni , and Alessandro Squizzato Extended-Duration Venous Thromboembolism Prophylaxis for Medical Patients Jose A. Nieto , Reina Valle , and Juan B. Lopez-Saez Extended-Duration Venous Thromboembolism Prophylaxis for Medical Patients Michael P. Carson and Yen-Hong Kuo Metrics 16 November 2010Volume 153, Issue 10Page: 689-690KeywordsAbsolute risk reductionAnticoagulantsAntiplatelet therapyConflicts of interestDisclosureHemorrhageMultivariate analysisProphylaxisSafetyVenous thromboembolism ePublished: 16 November 2010 Issue Published: 16 November 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...