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Benefits of Extended Anticoagulation May Not Last

New study suggests that oral anticoagulant meds may be needed for the very long term

WEDNESDAY, July 8, 2015 (HealthDay News) — The benefit of extended anticoagulation after pulmonary embolism dissipates after cessation of active therapy, according to a study published in the July 7 issue of 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 percent of those taking warfarin, compared to 13.5 percent 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.

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