Quels patients traiter au long cours pour une MTEV, et avec quoi ? (Revue)

Titre original : 
Who should get long-term anticoagulant therapy for venous thromboembolism and with what?
Titre en français : 
Quels patients traiter au long cours pour une MTEV, et avec quoi ? (Revue)
Auteurs : 
Rodger MA, Le Gal G.
Revue : 
Blood Adv. 2018 Nov 13;2(21):3081-3087.




Résumé : 

After an initial 3 to 6 months of anticoagulation for venous thromboembolism (VTE), clinicians and patients face an important question: "Do we stop anticoagulants or continue them indefinitely?" The decision is easy in some scenarios (eg, stop in VTE provoked by major surgery). In most scenarios, which are faced on a day-to-day basis in routine practice, it is a challenging decision because of uncertainty in estimates in the long-term risks (principally major bleeding) and benefits (reducing recurrent VTE) and the tight trade-offs between them. Once the decision is made to continue, the next question to tackle is "Which anticoagulant?" Here again, it is a difficult decision because of the uncertainty with regard to estimates of efficacy and the safety of anticoagulant options and the tight trade-offs between choices. We conclude with the approach that we take in our clinical practice