Key result
Real-world physicians discontinue anticoagulation in ~59% of patients with recent VTE.
Why the study?
Decisions regarding the duration of anticoagulant treatment in patients with venous thromboembolism are often challenging to make.
What factors influence the decision to extend or stop anticoagulant treatment after VTE in real-world practice?
Observational (n=705)
Yes
What factors influence the decision to extend or stop anticoagulant treatment after VTE in real-world practice?
Absolute Event Rate: 59.3% vs 40.7%
In real-world Italian practice, decisions on anticoagulant duration after VTE are multifactorial, with most patients receiving at least 3 months of therapy and extension driven by high recurrence risk or thrombophilia.
Real-world VTE anticoagulation decisions favor discontinuation in most cases; leaves open optimal duration, guideline adherence, and outcomes.
Patients with venous thromboembolism (VTE) should receive a decision on the duration of anticoagulant treatment (AT) that is often not easy to make. Sixteen Italian clinical centers included patients with recent VTE in the START2-POST-VTE register and reported the decisions taken on duration of AT in each patient and the reasons for them. At the moment of this report, 472 (66.9%) of the 705 patients included in the registry were told to stop AT in 59.3% and to extend it in 40.7% of patients. Anticoagulant treatment lasted ≥3 months in >90% of patients and was extended in patients with proximal deep vein thrombosis because considered at high risk of recurrence or had thrombophilic abnormalities. d-dimer testing, assessment of residual thrombus, and patient preference were also indicated among the criteria influencing the decision. In conclusion, Italian doctors stuck to the minimum 3 months AT after VTE, while the secondary or unprovoked nature of the event was not seen as the prevalent factor influencing AT duration which instead was the result of a complex and multifactorial evaluation of each patient.
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Antonucci et al. (2020) conducted an observational in Venous thromboembolism (n=705). Anticoagulant treatment duration decision vs. Unexposed/Reference was evaluated on Decision to stop or extend anticoagulant treatment. In a real-world registry of patients with recent venous thromboembolism, physicians decided to discontinue anticoagulant treatment in 59.3% of patients and extend it in 40.7%.
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