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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Antithrombotic Therapy for VTE Disease</title><author><name sortKey="Kearon, Clive" sort="Kearon, Clive" uniqKey="Kearon C" first="Clive" last="Kearon">Clive Kearon</name></author><author><name sortKey="Akl, Elie A" sort="Akl, Elie A" uniqKey="Akl E" first="Elie A." last="Akl">Elie A. Akl</name></author><author><name sortKey="Comerota, Anthony J" sort="Comerota, Anthony J" uniqKey="Comerota A" first="Anthony J." last="Comerota">Anthony J. Comerota</name></author><author><name sortKey="Prandoni, Paolo" sort="Prandoni, Paolo" uniqKey="Prandoni P" first="Paolo" last="Prandoni">Paolo Prandoni</name></author><author><name sortKey="Bounameaux, Henri" sort="Bounameaux, Henri" uniqKey="Bounameaux H" first="Henri" last="Bounameaux">Henri Bounameaux</name></author><author><name sortKey="Goldhaber, Samuel Z" sort="Goldhaber, Samuel Z" uniqKey="Goldhaber S" first="Samuel Z." last="Goldhaber">Samuel Z. Goldhaber</name></author><author><name sortKey="Nelson, Michael E" sort="Nelson, Michael E" uniqKey="Nelson M" first="Michael E." last="Nelson">Michael E. Nelson</name></author><author><name sortKey="Wells, Philip S" sort="Wells, Philip S" uniqKey="Wells P" first="Philip S." last="Wells">Philip S. Wells</name></author><author><name sortKey="Gould, Michael K" sort="Gould, Michael K" uniqKey="Gould M" first="Michael K." last="Gould">Michael K. Gould</name></author><author><name sortKey="Dentali, Francesco" sort="Dentali, Francesco" uniqKey="Dentali F" first="Francesco" last="Dentali">Francesco Dentali</name></author><author><name sortKey="Crowther, Mark" sort="Crowther, Mark" uniqKey="Crowther M" first="Mark" last="Crowther">Mark Crowther</name></author><author><name sortKey="Kahn, Susan R" sort="Kahn, Susan R" uniqKey="Kahn S" first="Susan R." last="Kahn">Susan R. Kahn</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22315268</idno><idno type="pmc">3278049</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278049</idno><idno type="RBID">PMC:3278049</idno><idno type="doi">10.1378/chest.11-2301</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002D47</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D47</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Antithrombotic Therapy for VTE Disease</title><author><name sortKey="Kearon, Clive" sort="Kearon, Clive" uniqKey="Kearon C" first="Clive" last="Kearon">Clive Kearon</name></author><author><name sortKey="Akl, Elie A" sort="Akl, Elie A" uniqKey="Akl E" first="Elie A." last="Akl">Elie A. Akl</name></author><author><name sortKey="Comerota, Anthony J" sort="Comerota, Anthony J" uniqKey="Comerota A" first="Anthony J." last="Comerota">Anthony J. Comerota</name></author><author><name sortKey="Prandoni, Paolo" sort="Prandoni, Paolo" uniqKey="Prandoni P" first="Paolo" last="Prandoni">Paolo Prandoni</name></author><author><name sortKey="Bounameaux, Henri" sort="Bounameaux, Henri" uniqKey="Bounameaux H" first="Henri" last="Bounameaux">Henri Bounameaux</name></author><author><name sortKey="Goldhaber, Samuel Z" sort="Goldhaber, Samuel Z" uniqKey="Goldhaber S" first="Samuel Z." last="Goldhaber">Samuel Z. Goldhaber</name></author><author><name sortKey="Nelson, Michael E" sort="Nelson, Michael E" uniqKey="Nelson M" first="Michael E." last="Nelson">Michael E. Nelson</name></author><author><name sortKey="Wells, Philip S" sort="Wells, Philip S" uniqKey="Wells P" first="Philip S." last="Wells">Philip S. Wells</name></author><author><name sortKey="Gould, Michael K" sort="Gould, Michael K" uniqKey="Gould M" first="Michael K." last="Gould">Michael K. Gould</name></author><author><name sortKey="Dentali, Francesco" sort="Dentali, Francesco" uniqKey="Dentali F" first="Francesco" last="Dentali">Francesco Dentali</name></author><author><name sortKey="Crowther, Mark" sort="Crowther, Mark" uniqKey="Crowther M" first="Mark" last="Crowther">Mark Crowther</name></author><author><name sortKey="Kahn, Susan R" sort="Kahn, Susan R" uniqKey="Kahn S" first="Susan R." last="Kahn">Susan R. Kahn</name></author></analytic><series><title level="j">Chest</title><idno type="ISSN">0012-3692</idno><idno type="eISSN">1931-3543</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>This article addresses the treatment of VTE disease.</p></sec><sec><title>Methods:</title><p>We generated strong (Grade 1) and weak (Grade 2) recommendations based on
high-quality (Grade A), moderate-quality (Grade B), and low-quality (Grade
C) evidence.</p></sec><sec><title>Results:</title><p>For acute DVT or pulmonary embolism (PE), we recommend initial parenteral
anticoagulant therapy (Grade 1B) or anticoagulation with rivaroxaban. We
suggest low-molecular-weight heparin (LMWH) or fondaparinux over IV
unfractionated heparin (Grade 2C) or subcutaneous unfractionated heparin
(Grade 2B). We suggest thrombolytic therapy for PE with hypotension (Grade
2C). For proximal DVT or PE, we recommend treatment of 3 months over shorter
periods (Grade 1B). For a first proximal DVT or PE that is provoked by
surgery or by a nonsurgical transient risk factor, we recommend 3 months of
therapy (Grade 1B; Grade 2B if provoked by a nonsurgical risk factor and low
or moderate bleeding risk); that is unprovoked, we suggest extended therapy
if bleeding risk is low or moderate (Grade 2B) and recommend 3 months of
therapy if bleeding risk is high (Grade 1B); and that is associated with
active cancer, we recommend extended therapy (Grade 1B; Grade 2B if high
bleeding risk) and suggest LMWH over vitamin K antagonists (Grade 2B). We
suggest vitamin K antagonists or LMWH over dabigatran or rivaroxaban (Grade
2B). We suggest compression stockings to prevent the postthrombotic syndrome
(Grade 2B). For extensive superficial vein thrombosis, we suggest
prophylactic-dose fondaparinux or LMWH over no anticoagulation (Grade 2B),
and suggest fondaparinux over LMWH (Grade 2C).</p></sec><sec><title>Conclusion:</title><p>Strong recommendations apply to most patients, whereas weak recommendations
are sensitive to differences among patients, including their
preferences.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Chest</journal-id><journal-id journal-id-type="iso-abbrev">Chest</journal-id><journal-id journal-id-type="hwp">chest</journal-id><journal-id journal-id-type="pmc">chest</journal-id><journal-id journal-id-type="publisher-id">Chest</journal-id><journal-title-group><journal-title>Chest</journal-title></journal-title-group><issn pub-type="ppub">0012-3692</issn><issn pub-type="epub">1931-3543</issn><publisher><publisher-name>American College of Chest Physicians</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22315268</article-id><article-id pub-id-type="pmc">3278049</article-id><article-id pub-id-type="publisher-id">112301</article-id><article-id pub-id-type="doi">10.1378/chest.11-2301</article-id><article-categories><subj-group subj-group-type="heading"><subject>Antithrombotic Therapy and Prevention of Thrombosis, 9th Ed: American College of Chest Physician Evidence-Based Clinical Practice Guidelines Online Only Articles</subject></subj-group></article-categories><title-group><article-title>Antithrombotic Therapy for VTE Disease</article-title><subtitle>Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American
College of Chest Physicians Evidence-Based Clinical Practice
Guidelines</subtitle><alt-title alt-title-type="short">Antithrombotic Therapy for VTE</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kearon</surname><given-names>Clive</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Akl</surname><given-names>Elie A.</given-names></name><degrees>MD, MPH, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Comerota</surname><given-names>Anthony J.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Prandoni</surname><given-names>Paolo</given-names></name><degrees>MD, PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Bounameaux</surname><given-names>Henri</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Goldhaber</surname><given-names>Samuel Z.</given-names></name><degrees>MD, FCCP</degrees></contrib><contrib contrib-type="author"><name><surname>Nelson</surname><given-names>Michael E.</given-names></name><degrees>MD, FCCP</degrees></contrib><contrib contrib-type="author"><name><surname>Wells</surname><given-names>Philip S.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Gould</surname><given-names>Michael K.</given-names></name><degrees>MD, FCCP</degrees></contrib><contrib contrib-type="author"><name><surname>Dentali</surname><given-names>Francesco</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Crowther</surname><given-names>Mark</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Kahn</surname><given-names>Susan R.</given-names></name><degrees>MD</degrees></contrib><aff id="aff1">From the Departments of Medicine and Clinical Epidemiology and Biostatistics (Dr Kearon), Michael De Groote School of Medicine, McMaster University, Hamilton, ON, Canada; Departments of Medicine, Family Medicine, and Social and Preventive Medicine (Dr Akl), State University of New York at Buffalo, Buffalo, NY; Department of Surgery (Dr Comerota), Jobst Vascular Center, Toledo, OH; Department of Cardiothoracic and Vascular Sciences (Dr Prandoni), University of Padua, Padua, Italy; Department of Medical Specialties (Dr Bounameaux), University Hospitals of Geneva, Geneva, Switzerland; Department of Medicine (Dr Goldhaber), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; Department of Medicine (Dr Nelson), Shawnee Mission Medical Center, Shawnee Mission, KS; Department of Medicine (Dr Wells), University of Ottawa, Ottawa, ON, Canada; Departments of Medicine and Preventive Medicine (Dr Gould), Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Medicine (Dr Dentali), University of Insubria, Varese, Italy; Department of Medicine (Dr Crowther), Michael De Groote School of Medicine, McMaster University, Hamilton, ON, Canada; and Departments of Medicine and Clinical Epidemiology and Biostatistics (Dr Kahn), McGill University, Montreal, QC, Canada.</aff></contrib-group><author-notes><corresp id="cor1"><bold>Correspondence to:</bold> Elie A. Akl, MD, MPH, PhD,
Department of Medicine, State University of New York at Buffalo, ECMC-CC 142,
462 Grider St, Buffalo, NY 14215; e-mail:
<email>elieakl@buffalo.edu</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>23</day><month>1</month><year>2012</year></pub-date><volume>141</volume><issue>2 Suppl</issue><issue-title>Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American
College of Chest Physicians Evidence-Based Clinical Practice
Guidelines</issue-title><fpage>e419S</fpage><lpage>e494S</lpage><history><date date-type="accepted"><day>31</day><month>8</month><year>2011</year></date></history><permissions><copyright-statement>© 2012 American College of Chest
Physicians</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="112301.pdf"></self-uri><abstract><sec><title>Background:</title><p>This article addresses the treatment of VTE disease.</p></sec><sec><title>Methods:</title><p>We generated strong (Grade 1) and weak (Grade 2) recommendations based on
high-quality (Grade A), moderate-quality (Grade B), and low-quality (Grade
C) evidence.</p></sec><sec><title>Results:</title><p>For acute DVT or pulmonary embolism (PE), we recommend initial parenteral
anticoagulant therapy (Grade 1B) or anticoagulation with rivaroxaban. We
suggest low-molecular-weight heparin (LMWH) or fondaparinux over IV
unfractionated heparin (Grade 2C) or subcutaneous unfractionated heparin
(Grade 2B). We suggest thrombolytic therapy for PE with hypotension (Grade
2C). For proximal DVT or PE, we recommend treatment of 3 months over shorter
periods (Grade 1B). For a first proximal DVT or PE that is provoked by
surgery or by a nonsurgical transient risk factor, we recommend 3 months of
therapy (Grade 1B; Grade 2B if provoked by a nonsurgical risk factor and low
or moderate bleeding risk); that is unprovoked, we suggest extended therapy
if bleeding risk is low or moderate (Grade 2B) and recommend 3 months of
therapy if bleeding risk is high (Grade 1B); and that is associated with
active cancer, we recommend extended therapy (Grade 1B; Grade 2B if high
bleeding risk) and suggest LMWH over vitamin K antagonists (Grade 2B). We
suggest vitamin K antagonists or LMWH over dabigatran or rivaroxaban (Grade
2B). We suggest compression stockings to prevent the postthrombotic syndrome
(Grade 2B). For extensive superficial vein thrombosis, we suggest
prophylactic-dose fondaparinux or LMWH over no anticoagulation (Grade 2B),
and suggest fondaparinux over LMWH (Grade 2C).</p></sec><sec><title>Conclusion:</title><p>Strong recommendations apply to most patients, whereas weak recommendations
are sensitive to differences among patients, including their
preferences.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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