Duration of anticoagulation of venous thromboembolism.

Pierre-Emmanuel Morange, David Jimenez, Nicolas Meneveau, Francis Couturaud, Marie Antoinette Sevestre

Journal: Presse medicale (Paris, France : 1983) 2024;53(3):104245

PMID: 39244021

Full Text on Elsevier Science View on PubMed

Abstract

Venous thromboembolism (VTE) is a common, serious condition that requires anticoagulation for at least three months to prevent recurrence and long-term complications. After this initial period, the decision to continue or stop anticoagulation depends on the balance between the risk of recurrent VTE and the risk of bleeding. Established guidelines suggest short-term anticoagulation for VTE caused by transient factors and indefinite anticoagulation for recurrent or cancer-associated VTE. However, for a first unprovoked VTE, decision-making remains challenging. Current predictive scores for recurrence and bleeding are not sufficiently reliable, and the safety and efficacy of reduced-dose anticoagulation remain unclear. In the future, precision and patient-centred medicine may improve treatment decisions in this area.

Address: CHU Brest, Département de Médecine Interne et Pneumologie, Brest, France; Univ_Brest, INSERM U1304-GETBO, CIC INSERM 1412, F29609 Brest, France; FCRIN INNOVTE network, Saint-Etienne, France. Electronic address: [email protected].; Department of Cardiology, University Hospital Besançon, 25000 Besançon, France; EA3920, University of Franche-Comté, 25000 Besançon, France.; Service de médecine vasculaire, EA Chimère 7516, CHU d'Amiens-Picardie, Amiens, France.; Aix-Marseille University, INSERM, INRAE, Centre de Recherche en CardioVasculaire et Nutrition, Laboratory of Haematology, CRB Assistance Publique - Hôpitaux de Marseille, Marseille, France.; Respiratory Department, Ramón y Cajal Hospital (IRICYS), Madrid, Spain; Medicine Department, Universidad de Alcalá (IRICYS), Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.

DOI: 10.1016/j.lpm.2024.104245

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MeSH Terms: Humans, Venous Thromboembolism, Anticoagulants, Hemorrhage, Recurrence, Time Factors, Duration of Therapy, Drug Administration Schedule