The DOI matches its Crossref record; 610 of the 610 references it cites were found in a registry or an index.
Antithrombotic Therapy for VTE Disease
Abstract
Background We update recommendations on 12 topics that were in the 9th edition of these guidelines, and address 3 new topics.Methods We generate strong (Grade 1) and weak (Grade 2) recommendations based on high- (Grade A), moderate- (Grade B), and low- (Grade C) quality evidence.Results For VTE and no cancer, as long-term anticoagulant therapy, we suggest dabigatran (Grade 2B), rivaroxaban (Grade 2B), apixaban (Grade 2B), or edoxaban (Grade 2B) over vitamin K antagonist (VKA) therapy, and suggest VKA therapy over low-molecular-weight heparin (LMWH; Grade 2C). For VTE and cancer, we suggest LMWH over VKA (Grade 2B), dabigatran (Grade 2C), rivaroxaban (Grade 2C), apixaban (Grade 2C), or edoxaban (Grade 2C). We have not changed recommendations for who should stop anticoagulation at 3 months or receive extended therapy. For VTE treated with anticoagulants, we recommend against an inferior vena cava filter (Grade 1B). For DVT, we suggest not using compression stockings routinely to prevent PTS (Grade 2B). For subsegmental pulmonary embolism and no proximal DVT, we suggest clinical surveillance over anticoagulation with a low risk of recurrent VTE (Grade 2C), and anticoagulation over clinical surveillance with a high risk (Grade 2C). We suggest thrombolytic therapy for pulmonary embolism with hypotension (Grade 2B), and systemic therapy over catheter-directed thrombolysis (Grade 2C). For recurrent VTE on a non-LMWH anticoagulant, we suggest LMWH (Grade 2C); for recurrent VTE on LMWH, we suggest increasing the LMWH dose (Grade 2C).Conclusions Of 54 recommendations included in the 30 statements, 20 were strong and none was based on high-quality evidence, highlighting the need for further research.
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“Direct-acting oral anticoagulants (DOACs) such as dabigatran, apixaban, rivaroxaban, and edoxaban are becoming the preferred agents for use in acute venous thromboembolism (VTE; deep vein thrombosis and pulmonary embolism) compared with vitamin K antagonists (VKAs). 1”
From Systematic review and meta-analysis of the efficacy and safety of apixaban compared to rivaroxaban in acute VTE in the real world (2019) · cites this paper as [1]
In the citing paper
“current guidelines suggest extended (ie, indefinite) anticoagulation in patients with unprovoked proximal deep vein thrombosis or pulmonary embolism who have a non-high bleeding risk.6 7 8”
In the citing paper
“as suggested by current guidelines,6 7 it is unlikely that patients with a major bleeding risk that exceeds 3% a year would ever experience a net long term mortality benefit from indefinite anticoagulation.”
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Metadata
- Authors
- Kearon, C., Akl, E. A., Ornelas, J., Blaivas, A., Jimenez, D., Bounameaux, H., Huisman, M., King, C. S., Morris, T. A., Sood, N., Stevens, S. M., Vintch, J. R. E., Wells, P., Woller, S. C., & Moores, L.
- Affiliations
- McMaster University (CA)
- American College of Chest Physicians (US)
- VA New Jersey Health Care System (US)
- University of Geneva (CH)
- Leiden University Medical Center (NL)
- Virginia Commonwealth University (US)
- University of California San Diego (US)
- The Ohio State University (US)
- University of Utah (US)
- Harbor–UCLA Medical Center (US)
- University of Ottawa (CA)
- Uniformed Services University of the Health Sciences (US)
- Corresponding author
- Akl, Elie A.
- ORCID
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 149
- Issue
- 2
- Pages
- 315-352
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2225937646
- Cited by
- 4,830
- References
- 610
- Citations by year
- 2026: 173 · 2025: 244 · 2024: 270 · 2023: 321 · 2022: 420 · 2021: 630 · 2020: 697 · 2019: 607 · 2018: 621 · 2017: 530 · 2016: 244
- FWCI
- 627.82
- Type
- journal article
- Language
- en
- Update notices
- erratum (2016-10-01)
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American College of Chest Physicians
- 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, antithrombotic therapy, anticoagulation, dabigatran, rivaroxaban, apixaban, edoxaban, vitamin K antagonists, low molecular weight heparin, cancer-associated thrombosis, inferior vena cava filter, post-thrombotic syndrome, compression stockings, subsegmental pulmonary embolism, thrombolysis, recurrent venous thromboembolism, catheter-directed thrombolysis
- MeSH terms
- Drug Administration Schedule, Fibrinolytic Agents, Humans, Societies, Medical, Evidence-Based Medicine, International Normalized Ratio, Venous Thrombosis
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