Fondazione Arianna Anticoagulazione, Bologna, Italy.
Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, A. Bianchi Bonomi Hemophilia and Thrombosis Center, Milano, Italy.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620945792. doi: 10.1177/1076029620945792.
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.
静脉血栓栓塞症（VTE）患者应就抗凝治疗（AT）的持续时间做出决定，但这通常并不容易。16 家意大利临床中心在 START2-POST-VTE 登记处纳入了近期 VTE 患者，并报告了每位患者 AT 持续时间的决策及其原因。在本报告之时，登记处纳入的 705 例患者中有 472 例（66.9%）被告知停止 AT，59.3%的患者停止 AT，40.7%的患者延长 AT。>90%的患者抗凝治疗持续时间≥3 个月，并且在近端深静脉血栓形成患者中延长 AT，因为这些患者被认为有较高的复发风险或存在血栓形成异常。D-二聚体检测、残余血栓评估和患者偏好也是影响决策的标准。总之，意大利医生坚持在 VTE 后至少进行 3 个月的 AT，而事件的继发性或自发性并不是影响 AT 持续时间的主要因素，而是对每位患者进行复杂和多因素评估的结果。
