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International Angiology 2017 October;36(5):395-401

DOI: 10.23736/S0392-9590.16.03785-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Optimal duration of anticoagulation in patients with unprovoked venous thromboembolism: the impact of novel anticoagulants

Paolo PRANDONI , Marta MILAN, Lucia SAROLO, Ezio ZANON, Franca BILORA

Unit of Vascular Medicine, Department of Cardiovascular Sciences, University of Padua, Padua, Italy


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Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years approaches 50% of all patients with a first episode of unprovoked VTE. The persistence of residual vein thrombosis at ultrasound assessment has consistently been shown to increase the risk, as do persistently high values of D-dimer. Although the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, strategies that incorporate the assessment of residual vein thrombosis and D-dimer have the potential to identify a substantial proportion of subjects in whom anticoagulation can be safely discontinued. For those patients in whom anticoagulation cannot be discontinued, new opportunities are offered by the availability of low-dose anti-Xa compounds, which have been found to possess an extremely favourable benefit/risk profile.


KEY WORDS: Venous thromboembolism - Venous thrombosis - Pulmonary embolism - Blood coagulation - Fibrin fragment D - Anticoagulants

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