Proposed durations of anticoagulant treatment following venous thromboembolism (VTE) according to widely used guidelines.*
| Indication . | 7th ACCP guidelines14 . | 8th ACCP guidelines15 . | BTS guidelines8 . |
|---|---|---|---|
| * All recommendations are subject to modification by individual characteristics including patient preference, age, co-morbidity, bleeding risk, and likelihood of recurrence. | |||
| † Transient or time-limited risk factors include: surgery, trauma, immobilization, estrogen use. | |||
| ‡ Proper duration of therapy is unclear in first event with homozygous factor V Leiden, homocystinemia, deficiency of protein C or S, or multiple thrombophilias; and in recurrent events with reversible risk factors. Long-term anticoagulation is suggested in high risk thrombophilias (e.g., antithrombin deficiency, antiphospholipid syndrome) | |||
| Abbreviations: ACCP, American College of Chest Physicians; BTS, British Thoracic Society | |||
| First episode of VTE secondary to a transient risk factor† | At least 3 months (Grade 1A). | 3 months (Grade 1A). | 4–6 weeks (Grade A). |
| First episode of idiopathic (unprovoked) VTE | At least 6–12 months (Grade 1A). | At least 3 months (Grade 1A). | 3 months (Grade A). |
| Consider indefinite (Grade 2A). | After 3 months, evaluate risk-benefit ratio of long-term treatment (Grade 1C). In case of favorable risk-benefit ratio, long-term treatment (Grade 1A). | ||
| Other (recurrent, active cancer, …)‡ | 12 months to lifetime (Grade 2A). | Long term (Grade 1A). | At least 6 months (Grade C). |
| Indication . | 7th ACCP guidelines14 . | 8th ACCP guidelines15 . | BTS guidelines8 . |
|---|---|---|---|
| * All recommendations are subject to modification by individual characteristics including patient preference, age, co-morbidity, bleeding risk, and likelihood of recurrence. | |||
| † Transient or time-limited risk factors include: surgery, trauma, immobilization, estrogen use. | |||
| ‡ Proper duration of therapy is unclear in first event with homozygous factor V Leiden, homocystinemia, deficiency of protein C or S, or multiple thrombophilias; and in recurrent events with reversible risk factors. Long-term anticoagulation is suggested in high risk thrombophilias (e.g., antithrombin deficiency, antiphospholipid syndrome) | |||
| Abbreviations: ACCP, American College of Chest Physicians; BTS, British Thoracic Society | |||
| First episode of VTE secondary to a transient risk factor† | At least 3 months (Grade 1A). | 3 months (Grade 1A). | 4–6 weeks (Grade A). |
| First episode of idiopathic (unprovoked) VTE | At least 6–12 months (Grade 1A). | At least 3 months (Grade 1A). | 3 months (Grade A). |
| Consider indefinite (Grade 2A). | After 3 months, evaluate risk-benefit ratio of long-term treatment (Grade 1C). In case of favorable risk-benefit ratio, long-term treatment (Grade 1A). | ||
| Other (recurrent, active cancer, …)‡ | 12 months to lifetime (Grade 2A). | Long term (Grade 1A). | At least 6 months (Grade C). |