Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study

Background International guidelines recommend at least three months anticoagulation in all patients after acute venous thromboembolism (VTE) and suggest those with unprovoked events be considered for indefinite anticoagulation if the risk of recurrence is high and the risk of bleeding during treatme...

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Autores principales:	Gualtiero Palareti MD, Angelo A. Bignamini MD, Michela Cini PhD, Young-Jun Li MD, Tomasz Urbanek MD, Juraj Madaric MD, Kamel Bouslama MD, German Y. Sokurenko MD, Giuseppe M. Andreozzi MD, Jiří Matuška MD, Armando Mansilha MD, Victor Barinov MD
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/9dc7d1f96b004974aa66dfd6b56b529e
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spelling	oai:doaj.org-article:9dc7d1f96b004974aa66dfd6b56b529e2021-12-02T01:33:38ZAnticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study1938-272310.1177/10760296211049402https://doaj.org/article/9dc7d1f96b004974aa66dfd6b56b529e2021-11-01T00:00:00Zhttps://doi.org/10.1177/10760296211049402https://doaj.org/toc/1938-2723Background International guidelines recommend at least three months anticoagulation in all patients after acute venous thromboembolism (VTE) and suggest those with unprovoked events be considered for indefinite anticoagulation if the risk of recurrence is high and the risk of bleeding during treatment non-high. Other authors have recently argued against using a dichotomy unprovoked/provoked events to decide on anticoagulation duration and suggest instead using overall risk factors present in each patient as the basis for deciding. Aim This sub-analysis of the WHITE study aimed at assessing the reasons for the treatment decisions taken by doctors in different countries. Results 1240 patients were recruited in 7 countries (China, Czechia, Poland, Portugal, Russia, Slovakia, and Tunisia). Anticoagulation was extended in 51.7% and 49.3% of patients with unprovoked or provoked events (n.s.); stopped in 15.4% versus 28.9% ( P < .0001), and changed to antithrombotic drugs (sulodexide or aspirin) in 32.9% versus 21.8% ( P < .0001). In the 430 subjects with isolated distal deep vein thrombosis (IDDVT) anticoagulation was stopped in 34.4%, continued in 37.0% (mainly those with post-thrombotic syndrome [PTS]) and switched to antithrombotics in the balance. High risk of recurrence was the most prevalent reason (>83% of cases) given to continue anticoagulation, regardless of nature and site of the index events, followed by risk of bleeding and presence of PTS signs. Conclusion On average, attending physicians estimated the risk of recurrence in real life conditions, and the consequent therapeutic decision, using all the information available, not limiting to the location or nature of the index event.Gualtiero Palareti MDAngelo A. Bignamini MDMichela Cini PhDYoung-Jun Li MDTomasz Urbanek MDJuraj Madaric MDKamel Bouslama MDGerman Y. Sokurenko MDGiuseppe M. Andreozzi MDJiří Matuška MDArmando Mansilha MDVictor Barinov MDSAGE PublishingarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENClinical and Applied Thrombosis/Hemostasis, Vol 27 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Gualtiero Palareti MD Angelo A. Bignamini MD Michela Cini PhD Young-Jun Li MD Tomasz Urbanek MD Juraj Madaric MD Kamel Bouslama MD German Y. Sokurenko MD Giuseppe M. Andreozzi MD Jiří Matuška MD Armando Mansilha MD Victor Barinov MD Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
description	Background International guidelines recommend at least three months anticoagulation in all patients after acute venous thromboembolism (VTE) and suggest those with unprovoked events be considered for indefinite anticoagulation if the risk of recurrence is high and the risk of bleeding during treatment non-high. Other authors have recently argued against using a dichotomy unprovoked/provoked events to decide on anticoagulation duration and suggest instead using overall risk factors present in each patient as the basis for deciding. Aim This sub-analysis of the WHITE study aimed at assessing the reasons for the treatment decisions taken by doctors in different countries. Results 1240 patients were recruited in 7 countries (China, Czechia, Poland, Portugal, Russia, Slovakia, and Tunisia). Anticoagulation was extended in 51.7% and 49.3% of patients with unprovoked or provoked events (n.s.); stopped in 15.4% versus 28.9% ( P < .0001), and changed to antithrombotic drugs (sulodexide or aspirin) in 32.9% versus 21.8% ( P < .0001). In the 430 subjects with isolated distal deep vein thrombosis (IDDVT) anticoagulation was stopped in 34.4%, continued in 37.0% (mainly those with post-thrombotic syndrome [PTS]) and switched to antithrombotics in the balance. High risk of recurrence was the most prevalent reason (>83% of cases) given to continue anticoagulation, regardless of nature and site of the index events, followed by risk of bleeding and presence of PTS signs. Conclusion On average, attending physicians estimated the risk of recurrence in real life conditions, and the consequent therapeutic decision, using all the information available, not limiting to the location or nature of the index event.
format	article
author	Gualtiero Palareti MD Angelo A. Bignamini MD Michela Cini PhD Young-Jun Li MD Tomasz Urbanek MD Juraj Madaric MD Kamel Bouslama MD German Y. Sokurenko MD Giuseppe M. Andreozzi MD Jiří Matuška MD Armando Mansilha MD Victor Barinov MD
author_facet	Gualtiero Palareti MD Angelo A. Bignamini MD Michela Cini PhD Young-Jun Li MD Tomasz Urbanek MD Juraj Madaric MD Kamel Bouslama MD German Y. Sokurenko MD Giuseppe M. Andreozzi MD Jiří Matuška MD Armando Mansilha MD Victor Barinov MD
author_sort	Gualtiero Palareti MD
title	Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
title_short	Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
title_full	Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
title_fullStr	Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
title_full_unstemmed	Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study
title_sort	anticoagulation duration after first venous thromboembolism: real-life data from the international, observational white study
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/9dc7d1f96b004974aa66dfd6b56b529e
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Anticoagulation Duration After First Venous Thromboembolism: Real-Life Data From the International, Observational WHITE Study

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