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Current guidelines recommend continuing anticoagulation indefinitely after a first unprovoked proximal deep venous thrombosis or pulmonary embolism, except in patients with high risk for bleeding (Chest 2021 Aug 2; [e-pub]; Blood Adv 2020; 4:4693). Investigators culled data from 14 randomized clinical trials and 13 prospective cohort studies (nearly 10,000 total patients) to determine the incidence of major bleeding in patients with a first unprovoked venous thromboembolism (VTE) who were treated for at least 6 additional months after initial anticoagulation for 3 to 6 months.
Annual rates of major bleeding among patients who received warfarin or direct-acting oral anticoagulants (DOACs) were 1.7% and 1.1%, respectively. Bleeding rates were …