Researchers from the RIETE group question the usual guidelines, due to the risk of bleeding

Knowing until when we should keep anticoagulant therapy in patients who have had a thrombosis is not always easy. That’s what a study done by doctors of the RIETE group show in a recently published article in Thrombosis Research.

Usual clinical practice usually extends more than expected the anticoagulant treatment, claim the authors of the article. Either because the doctor wants to make sure that the patient does not develop a new thrombosis or either because the patient does not want to leave the treatment. However, by keeping the treatment, both the doctor and the patient are exposed to another problem: the risk of bleeding, which is higher due to nature of the treatment.

RIETE investigators analysed the evolution of 6.944 patients with a first episode of VTE. Of these patients, 41% had unprovoked VTE, 32% had transient risk factors and 27% had cancer.

Clinical guidelines recommend a 3-months anticoagulant therapy in patients with certain risk factor that will disappear over time (like surgery, pregnancy, immobilization or a treatment with oestrogens). On the other hand, in patients with cancer or unknown cause for thrombosis, a 6-12 months therapy is recommended.

The study concluded that we should make a review of these guidelines, since the aim of avoiding a new thrombosis prevails over the fact of bleedings as a consequence of the treatment. And a bleeding can be more fatal than a new thrombosis.