Duration of Anticoagulation Following Venous Thromboembolism: A Meta-analysis
Abstract
Context Patients with venous thromboembolism (VTE) are susceptible to recurrent events, but whether prolonging anticoagulation is warranted in patients with VTE remains controversial. Objective To review the available evidence and quantify the risks and benefits of extending the duration of anticoagulation in patients with VTE. Data sources PubMed, EMBase Pharmacology, the Cochrane database, clinical trial Web sites, and a hand search of reference lists. Study selection Included studies were randomized controlled trials with results published from 1969 through 2004 and evaluating the duration of anticoagulation in patients with VTE that measured recurrent VTE. Excluded studies were those enrolling only pure populations of high-risk patients. Two independent reviewers assessed each article for inclusion and exclusion criteria, with adjudication by a third reviewer in cases of disagreement. Fifteen of 67 studies were included in the analysis. Data extraction Two independent reviewers performed data extraction using a standardized form, with adjudication by the remainder of the investigators in cases of disagreement. Data regarding recurrent VTE, major bleeding, person-time at risk, and study quality were extracted. Data synthesis If patients in the long-term therapy group remained receiving anticoagulation, the risk of recurrent VTE with long- vs short-term therapy was reduced (weighted incidence rate, 0.020 vs 0.126 events/person-year; rate difference, -0.106 [95% confidence i…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
After discontinuation of anticoagulant treatment, patients with a first unprovoked VTE have a much higher risk of recurrence compared with patients with VTE provoked by a major transient risk factor.
“After discontinuation of anticoagulant treatment, patients with a first unprovoked VTE have a much higher risk of recurrence compared with patients with VTE provoked by a major transient risk factor.3 4 5”
Cites
The Hazards of Scoring the Quality of Clinical Trials for Meta-analysis
Jüni, P. (1999) · JAMA · doi:10.1001/jama.282.11.1054 · Cited by 1,981 · see citing works
Antithrombotic Therapy for Venous Thromboembolic Disease
Büller, H. R., Agnelli, G., Hull, R. D., Hyers, T. M., Prins, M. H., & Raskob, G. E. (2004) · Chest · doi:10.1378/chest.126.3_suppl.401s · Cited by 1,249 · see citing works
Long-Term, Low-Intensity Warfarin Therapy for the Prevention of Recurrent Venous Thromboembolism
Ridker, P. M., Goldhaber, S. Z., Danielson, E., Rosenberg, Y., Eby, C. S., Deitcher, S. R., Cushman, M., Moll, S., Kessler, C. M., Elliott, C. G., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035029 · Cited by 808 · see citing works
Three Months versus One Year of Oral Anticoagulant Therapy for Idiopathic Deep Venous Thrombosis
Agnelli, G., Prandoni, P., Santamaria, M. G., Bagatella, P., Iorio, A., Bazzan, M., Moia, M., Guazzaloca, G., Bertoldi, A., Tomasi, C., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200107193450302 · Cited by 591 · see citing works
Heterogeneity in Meta-analysis of Data from Epidemiologic Studies: A Commentary
Colditz, G. A., Burdick, E., & Mosteller, F. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117644 · Cited by 245 · see citing works
Invited commentary: benefits of heterogeneity in meta-analysis of data from epidemiologic studies
Berlin, J. A. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117645 · Cited by 191 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ortel, T. L., Neumann, I., Ageno, W., Beyth, R., Clark, N. P., Cuker, A., Hutten, B. A., Jaff, M. R., Manja, V., Schulman, S., et al. (2020) · Blood Advances · doi:10.1182/bloodadvances.2020001830 · Cited by 1,489 · see citing works
Extended Use of Dabigatran, Warfarin, or Placebo in Venous Thromboembolism
Schulman, S., Kearon, C., Kakkar, A. K., Schellong, S., Eriksson, H., Baanstra, D., Kvamme, A. M., Friedman, J., Mismetti, P., & Goldhaber, S. Z. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1113697 · Cited by 983 · see citing works
Prandoni, P., Noventa, F., Ghirarduzzi, A., Pengo, V., Bernardi, E., Pesavento, R., Iotti, M., Tormene, D., Simioni, P., & Pagnan, A. (2007) · Haematologica · doi:10.3324/haematol.10516 · Cited by 776 · see citing works
Boutitie, F., Pinede, L., Schulman, S., Agnelli, G., Raskob, G., Julian, J., Hirsh, J., & Kearon, C. (2011) · BMJ · doi:10.1136/bmj.d3036 · Cited by 371 · see citing works
Khan, F., Rahman, A., Carrier, M., Kearon, C., Weitz, J. I., Schulman, S., Couturaud, F., Eichinger, S., Kyrle, P. A., Becattini, C., et al. (2019) · BMJ · doi:10.1136/bmj.l4363 · Cited by 328 · see citing works
Effect of patient's sex on risk of recurrent venous thromboembolism: a meta-analysis.
McRae, S., Tran, H., Schulman, S., Ginsberg, J., & Kearon, C. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69110-1 · Cited by 289 · see citing works
Prandoni, P., Prins, M. H., Lensing, A. W. A., Ghirarduzzi, A., Ageno, W., Imberti, D., Scannapieco, G., Ambrosio, G. B., Pesavento, R., Cuppini, S., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-150-9-200905050-00003 · Cited by 232 · see citing works
Rollins, B. M., Silva, M. A., Donovan, J. L., & Kanaan, A. O. (2014) · Clinical Therapeutics · doi:10.1016/j.clinthera.2014.06.033 · Cited by 18 · see citing works
Streiff, M. B., Segal, J. B., Tamariz, L. J., Jenckes, M. W., Bolger, D. T., Eng, J., Krishnan, J. A., & Bass, E. B. (2006) · American Journal of Hematology · doi:10.1002/ajh.20691 · Cited by 17 · see citing works
Holley, A. B., King, C. S., Jackson, J. L., & Moores, L. K. (2010) · Thrombosis · doi:10.1155/2010/540386 · Cited by 10 · see citing works
- Authors
- Ost, D., Tepper, J., Mihara, H., Lander, O., Heinzer, R., & Fein, A.
- Affiliations
- National University of Health Sciences (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2005-08-10
- Volume
- 294
- Issue
- 6
- Pages
- 706
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W177479855
- Cited by
- 3
- References
- 6
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- venous thromboembolism, anticoagulation duration, long-term anticoagulation, recurrent venous thromboembolism, major bleeding, anticoagulation discontinuation, risk-benefit assessment, thromboprophylaxis, randomized controlled trials review
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
