American College of Chest Physicians Offers New Guidelines on Antithrombosis for VTE

By Dr Deepu

The American College of Chest Physicians has issued new guidelines on antithrombotic therapy for venous thromboembolism (VTE), including guidance on use of non-vitamin K antagonist oral anticoagulants.
Among the recently changed or added recommendations, published in Chest:
  • For patients without cancer who have deep vein thrombosis (DVT) of the leg or pulmonary embolism (PE), the guidelines suggest using dabigatran, rivaroxaban, apixaban, or edoxaban instead of vitamin K antagonists for the first 3 months' treatment and beyond.
  • Patients with unprovoked proximal DVT or PE who are stopping anticoagulation should receive aspirin to reduce the risk for recurrent VTE, assuming aspirin is not contraindicated.
  • For patients who have acute DVT of the leg, compression stockings are not recommended to prevent post-thrombotic syndrome (PTS). However, for patients with PTS symptoms, "a trial of graduated compression stockings is often justified."
  • Patients with low-risk PE may be treated at home or receive an early discharge.

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