title: Optimal duration of anticoagulation in patients with unprovoked venous thromboembolism: the impact of novel anticoagulants.
abstract: Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years approaches 50% of all patients with a first episode of unprovoked VTE. The persistence of residual vein thrombosis at ultrasound assessment has consistently been shown to increase the risk, as do persistently high values of D-dimer. Although the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, strategies that incorporate the assessment of residual vein thrombosis and D-dimer have the potential to identify a substantial proportion of subjects in whom anticoagulation can be safely discontinued. For those patients in whom anticoagulation cannot be discontinued, new opportunities are offered by the availability of low-dose anti-Xa compounds, which have been found to possess an extremely favourable benefit/risk profile.
authors.affiliation: Unit of Vascular Medicine, Department of Cardiovascular Sciences, University of Padua, Padua, Italy - paoloprandoni@tin.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Prandoni
authors.affiliation: Unit of Vascular Medicine, Department of Cardiovascular Sciences, University of Padua, Padua, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Milan
authors.affiliation: Unit of Vascular Medicine, Department of Cardiovascular Sciences, University of Padua, Padua, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Sarolo
authors.affiliation: Unit of Vascular Medicine, Department of Cardiovascular Sciences, University of Padua, Padua, Italy.
authors.forename: Ezio
authors.initials: E
authors.lastname: Zanon
authors.affiliation: Unit of Vascular Medicine, Department of Cardiovascular Sciences, University of Padua, Padua, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Bilora
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001777:Blood Coagulation / Q000187:drug effects; D004334:Drug Administration Schedule; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D011655:Pulmonary Embolism / Q000097:blood / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000097:blood / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products