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Duration of Anticoagulant Therapy After First Episode of Venous Thrombosis in Patients With Inherited Thrombophilia

Jack Hirsh, MD; Clive Kearon, MB; Jeffrey Ginsberg, MD
Arch Intern Med. 1997;157(19):2174-2177. doi:10.1001/archinte.1997.00440400024003.
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PATIENTS WITH acute venous thrombosis or pulmonary embolism (PE) (venous thromboembolism [VTE]) are at high risk of recurrence unless they are treated with an adequate course of anticoagulants.1,2 Anticoagulant therapy is very effective for the treatment of VTE but is associated with bleeding.3 The risk of recurrence is highest early after the acute episode and then declines over time. Ideally, treatment should be continued until the benefits of treatment are offset by the risks, but this optimal duration is uncertain because both the risk of recurrence after discontinuing treatment and the risk of bleeding during anticoagulation therapy are not easily predicted in individual patients.

For most patients, the benefits of 3 to 6 months of anticoagulant therapy greatly outweigh the risks.1,4 In addition, some patients, for example those with familial thrombophilia, remain at high risk for recurrence even after completing such a course of anticoagulants5,6; consequently,


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