[Anticoagulation therapy during pulmonary embolism follow-up in clinical practice]. in Giornale italiano di cardiologia (2006) / G Ital Cardiol (Rome). 2023 Apr;24(4):275-284. doi: 10.1714/4004.39818.
2023
AO Cuneo
Tipo pubblicazione
Journal Article
Autori/Collaboratori (14)Vedi tutti...
Colivicchi F
U.O.C. Cardiologia, Presidio Ospedaliero San Filippo Neri - ASL Roma 1, Roma.
Gabrielli D
U.O.C. Cardiologia, Ospedale San Camillo Forlanini, Roma.
Bongarzoni A
U.O.C. Cardiologia, ASST Santi Paolo e Carlo, Milano.
et alii...
Abstract
Patients with pulmonary embolism are a heterogeneous population and, after the acute phase and the first 3-6 months, the main issue is whether to continue, and hence how long and at what dose, or to stop anticoagulation therapy. In patients with venous thromboembolism (VTE), direct oral anticoagulants (DOACs) are the recommended treatment (class I, level of evidence B in the latest European guidelines), and in most cases, an "extended" or "long-term" low-dose therapy is warranted. This paper aims to provide a practical management tool to the clinician dealing with pulmonary embolism follow-up: from the evidence behind the most used exams (D-dimer, ultrasound Doppler of the lower limbs, imaging tests, recurrence and bleeding risk scores), and the use of DOACs in the extended phase, to six real clinical scenarios with the relative management in the acute phase and at follow-up. Lastly, a practical algorithm is shown to deal with anticoagulation therapy in the follow-up of VTE patients in a simple, schematic, and pragmatic way.
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PMID : 36971171
DOI : 10.1714/4004.39818
Keywords
Administration, Oral; Recurrence; Hemorrhage/chemically induced; Pulmonary Embolism/drug therapy; Follow-Up Studies; Venous Thromboembolism/drug therapy; Anticoagulants/adverse effects; Humans;