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.