Extended Anticoagulation Benefits Disappear After Treatment
New study suggests that oral anticoagulant meds may be needed for the very long term for pulmonary embolism.
(HealthDay News) -- The benefit of extended anticoagulation after pulmonary embolism dissipates after cessation of active therapy, according to a study published in the Journal of the American Medical Association.
A team led by Francis Couturaud, M.D., Ph.D., of the Université de Bretagne Occidentale in Brest, France, tracked outcomes for 371 adults who had experienced a symptomatic unprovoked pulmonary embolism (i.e., with no major risk factor for thrombosis). All of the patients received six months of treatment with a vitamin K antagonist. At the six-month point, patients then received either warfarin for another 18 months, or a placebo.
Recurrent venous thromboembolism or major bleeding occurred in only 3.3% of those taking warfarin, compared to 13.5% of those taking the placebo. However, that benefit disappeared soon after treatment with warfarin ended. The findings suggest that this group of patients may require long-term treatment to prevent recurrence of pulmonary embolism, the researchers said.
"Whether these should include systematic treatment with vitamin K antagonists, new anticoagulants, or aspirin, or be tailored according to patient risk factors (including elevated D-dimer levels) needs further investigation," the authors write.