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2018 ; 2
(3
): 529-534
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Extended anticoagulation for unprovoked venous thromboembolism
#MMPMID30046758
Castellucci LA
; de Wit K
; Garcia D
; Ortel TL
; Le Gal G
Res Pract Thromb Haemost
2018[Jul]; 2
(3
): 529-534
PMID30046758
show ga
After completing anticoagulation therapy for acute venous thromboembolism (VTE),
patients with unprovoked VTE are at increased risk of recurrent thrombotic
events. Recent studies suggest a risk of nearly 10% in the first year after
stopping anticoagulants and 30% at 8 years. Therefore, it is important to
consider extended anticoagulation for secondary prevention in these high-risk
patients. While several oral anticoagulants are available for this purpose, there
is limited information available regarding the optimal agent to minimize bleeding
risks and maximize efficacy at VTE prevention. This review article summarizes the
evidence available for Vitamin-K antagonists (VKAs) and direct oral
anticoagulants (DOACs) for extended treatment of VTE. We also introduce the COVET
trial, the first head-to-head comparison of VKAs to DOACs, rivaroxaban and
apixaban, for extended management of unprovoked VTE.