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Anticoagulant therapy helps prevent recurrences of unprovoked venous thromboembolism (VTE), but the optimal duration of anticoagulation remains unclear. In a placebo-controlled French study of 370 patients with first unprovoked pulmonary embolism (PE), patients who received 24 months of warfarin had far fewer recurrent PEs than those who received 6 months of warfarin followed by 18 months of placebo. When warfarin recipients stopped receiving the drug at 24 months, their recurrence rate increased substantially during the subsequent 24 months of observation (NEJM JW Gen Med Aug 1 2015 and JAMA 2015; 314:31).
In another study of 410 patients with first unprovoked VTE, researchers performed d-dimer tests after 3 to 7 months of anticoagulation. …