CHEST issues new antithrombotic guideline update for treatment of VTE disease

Glenview, Ill.— Each year, there are approximately 10 million cases of venous thromboembolism (VTE) worldwide. VTE, the formation of blood clots in the vein, is a dangerous and potentially deadly medical condition and is a leading cause of death and disability worldwide. In this latest evidence-based guideline, Antithrombotic Therapy for VTE Disease: CHEST Guideline, from the American College of Chest Physicians, experts provide 53 updated recommendations for appropriate treatment of patients with VTE.

“This guideline article, another from CHEST living guidelines, provides the most up-to-date treatment options for patients with VTE. The guideline presents stronger recommendations and weaker suggestions for treatment based on the best available evidence, and identifies gaps in our knowledge and areas for future research,” said lead author Clive Kearon, MD, McMaster University.

Key changes to recommendations in the 9th edition to the 10th edition include:

Non-vitamin K antagonist oral anticoagulants (NOACs) are suggested over warfarin for initial and long-term treatment of VTE in patients without cancer. Since publication of the 9th edition, new studies show that NOACs are as effective as VKA therapy with reduced risk of bleeding and increased convenience for patients and health-care providers.

Since publication of the 9th edition, new studies show that NOACs are as effective as VKA therapy with reduced risk of bleeding and increased convenience for patients and health-care providers. Routine use of compression stockings is out to prevent postthrombotic syndrome in acute DVT. Based on recent evidence, the 10th edition suggests not to routinely use compression stockings to prevent postthrombotic syndrome in patients with acute DVT. Postthrombotic syndrome is a chronic condition of the leg with swelling, pain, skin discoloration, and even ulcers. In the 9th edition, compression stockings were routinely suggested as a preventive measure in these patients.

Based on recent evidence, the 10th edition suggests not to routinely use compression stockings to prevent postthrombotic syndrome in patients with acute DVT. Postthrombotic syndrome is a chronic condition of the leg with swelling, pain, skin discoloration, and even ulcers. In the 9th edition, compression stockings were routinely suggested as a preventive measure in these patients. New isolated subsegmental pulmonary embolism treatment recommendations. The 10th edition suggests which patients diagnosed with isolated subsegmental pulmonary embolism (SSPE) should, and should not, receive anticoagulant therapy.

To date, the updated guideline has been endorsed by American Association for Clinical Chemistry, American College of Clinical Pharmacy, International Society for Thrombosis and Haemostasis, and American Society of Health-System Pharmacists.

View the complete guideline on the journal CHEST website.

About CHEST living guidelines Living guidelines are systematically developed, evidence-based, and continually updated recommendations for the diagnosis and management of medical conditions. These guidelines are intended to inform both health-care providers and patients in making educated clinical decisions.

American College of Chest Physicians (CHEST), publisher of the journal CHEST, is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research, and team-based care. Its mission is to champion the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. CHEST serves as an essential connection to clinical knowledge and resources for its 18,700 members from around the world who provide patient care in pulmonary, critical care, and sleep medicine. CHEST Enterprises, Inc, a wholly owned subsidiary of CHEST, provides innovative education for health-care professionals and industry partners to advance best patient outcomes. For more information, visit chestnet.org.

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