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Stopping Anticoagulants 6 Months After Unprovoked VTE
Some patients with thromboembolism may safely stop anticoagulants after 6 months, reports an international study in the Canadian Medical Association Journal.
To identify those whose annual risk of recurrence was under 3%, researchers followed some 650 patients for a mean of 18 months. The patients had all received anticoagulant therapy for about 6 months after a first unprovoked episode of venous thromboembolism.
Men had a nearly 14% risk of recurrence, and no subgroup at low risk was identified. Among women, however, those having only one or none of the following risk factors — redness or edema in a leg, D-dimer level of 250 µg/L or more while on warfarin, BMI of 30 or more, or age of 65 or more — had a 1.6% recurrence risk. Those with two or more factors had a 14.1% risk.
A commentator notes that the American College of Chest Physicians recommends indefinite therapy in such patients. In that light, he calls for validation of the findings.
LINK(S):
CMAJ article (Free)
CMAJ commentary (Free)
ACCP Guidelines (Free abstract; full text requires subscription)
Published in Physician's First Watch August 26, 2008
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