Management of patients with unprovoked venous thromboembolism

An evidence-based and practical approach

Maura Marcucci, Alfonso Iorio, James Douketis

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Opinion statement: The management of patients with unprovoked venous thromboembolism is a common and challenging clinical problem. Although the initial antithrombotic management is well-established, there is uncertainty about the optimal long-term anticoagulant management, specifically whether patients should receive a short (i.e., 3- to 6-month) duration of anticoagulant therapy or indefinite anticoagulation. Factors that may be considered to estimate patients' risk for recurrent thromboembolism include the mode of initial clinical presentation, as deep vein thrombosis or pulmonary embolism, patient sex, antecedent hormonal therapy use, thrombophilia, D-dimer levels, and residual vein occlusion in patients with deep vein thrombosis. Many of these factors have been integrated into clinical prediction guides which stratify patients with unprovoked venous thromboembolism according to their risk for disease recurrence and, thereby, can assist clinicians in decisions about the duration of anticoagulation. The objective of this review is to consider the evidence relating to the clinical significance of purported risk factors and provide a practical case-based approach to guide decisions on duration of anticoagulation for patients with unprovoked venous thromboembolism.

Original languageEnglish
Pages (from-to)224-239
Number of pages16
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume15
Issue number2
DOIs
Publication statusPublished - Apr 2013

Fingerprint

Venous Thromboembolism
Venous Thrombosis
Anticoagulants
Thrombophilia
Thromboembolism
Pulmonary Embolism
Uncertainty
Veins
Recurrence
Therapeutics

Keywords

  • Clinical prediction guide
  • D-Dimer
  • Extended anticoagulation
  • Inherited thrombophilia
  • Residual vein occlusion
  • Risk factors
  • Unprovoked
  • Venous thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Management of patients with unprovoked venous thromboembolism : An evidence-based and practical approach. / Marcucci, Maura; Iorio, Alfonso; Douketis, James.

In: Current Treatment Options in Cardiovascular Medicine, Vol. 15, No. 2, 04.2013, p. 224-239.

Research output: Contribution to journalArticle

@article{9b443b0b071240e1a0fd0724ed81c196,
title = "Management of patients with unprovoked venous thromboembolism: An evidence-based and practical approach",
abstract = "Opinion statement: The management of patients with unprovoked venous thromboembolism is a common and challenging clinical problem. Although the initial antithrombotic management is well-established, there is uncertainty about the optimal long-term anticoagulant management, specifically whether patients should receive a short (i.e., 3- to 6-month) duration of anticoagulant therapy or indefinite anticoagulation. Factors that may be considered to estimate patients' risk for recurrent thromboembolism include the mode of initial clinical presentation, as deep vein thrombosis or pulmonary embolism, patient sex, antecedent hormonal therapy use, thrombophilia, D-dimer levels, and residual vein occlusion in patients with deep vein thrombosis. Many of these factors have been integrated into clinical prediction guides which stratify patients with unprovoked venous thromboembolism according to their risk for disease recurrence and, thereby, can assist clinicians in decisions about the duration of anticoagulation. The objective of this review is to consider the evidence relating to the clinical significance of purported risk factors and provide a practical case-based approach to guide decisions on duration of anticoagulation for patients with unprovoked venous thromboembolism.",
keywords = "Clinical prediction guide, D-Dimer, Extended anticoagulation, Inherited thrombophilia, Residual vein occlusion, Risk factors, Unprovoked, Venous thromboembolism",
author = "Maura Marcucci and Alfonso Iorio and James Douketis",
year = "2013",
month = "4",
doi = "10.1007/s11936-012-0225-2",
language = "English",
volume = "15",
pages = "224--239",
journal = "Current Treatment Options in Cardiovascular Medicine",
issn = "1092-8464",
publisher = "Current Science, Inc.",
number = "2",

}

TY - JOUR

T1 - Management of patients with unprovoked venous thromboembolism

T2 - An evidence-based and practical approach

AU - Marcucci, Maura

AU - Iorio, Alfonso

AU - Douketis, James

PY - 2013/4

Y1 - 2013/4

N2 - Opinion statement: The management of patients with unprovoked venous thromboembolism is a common and challenging clinical problem. Although the initial antithrombotic management is well-established, there is uncertainty about the optimal long-term anticoagulant management, specifically whether patients should receive a short (i.e., 3- to 6-month) duration of anticoagulant therapy or indefinite anticoagulation. Factors that may be considered to estimate patients' risk for recurrent thromboembolism include the mode of initial clinical presentation, as deep vein thrombosis or pulmonary embolism, patient sex, antecedent hormonal therapy use, thrombophilia, D-dimer levels, and residual vein occlusion in patients with deep vein thrombosis. Many of these factors have been integrated into clinical prediction guides which stratify patients with unprovoked venous thromboembolism according to their risk for disease recurrence and, thereby, can assist clinicians in decisions about the duration of anticoagulation. The objective of this review is to consider the evidence relating to the clinical significance of purported risk factors and provide a practical case-based approach to guide decisions on duration of anticoagulation for patients with unprovoked venous thromboembolism.

AB - Opinion statement: The management of patients with unprovoked venous thromboembolism is a common and challenging clinical problem. Although the initial antithrombotic management is well-established, there is uncertainty about the optimal long-term anticoagulant management, specifically whether patients should receive a short (i.e., 3- to 6-month) duration of anticoagulant therapy or indefinite anticoagulation. Factors that may be considered to estimate patients' risk for recurrent thromboembolism include the mode of initial clinical presentation, as deep vein thrombosis or pulmonary embolism, patient sex, antecedent hormonal therapy use, thrombophilia, D-dimer levels, and residual vein occlusion in patients with deep vein thrombosis. Many of these factors have been integrated into clinical prediction guides which stratify patients with unprovoked venous thromboembolism according to their risk for disease recurrence and, thereby, can assist clinicians in decisions about the duration of anticoagulation. The objective of this review is to consider the evidence relating to the clinical significance of purported risk factors and provide a practical case-based approach to guide decisions on duration of anticoagulation for patients with unprovoked venous thromboembolism.

KW - Clinical prediction guide

KW - D-Dimer

KW - Extended anticoagulation

KW - Inherited thrombophilia

KW - Residual vein occlusion

KW - Risk factors

KW - Unprovoked

KW - Venous thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=84879605067&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879605067&partnerID=8YFLogxK

U2 - 10.1007/s11936-012-0225-2

DO - 10.1007/s11936-012-0225-2

M3 - Article

VL - 15

SP - 224

EP - 239

JO - Current Treatment Options in Cardiovascular Medicine

JF - Current Treatment Options in Cardiovascular Medicine

SN - 1092-8464

IS - 2

ER -