The February issue of Chest includes the latest CHEST guideline on antithrombotic therapy for venous thromboembolism (VTE), representing the first installment in a series of updates of antithrombotic therapy. The guideline contains some significant changes from the previous CHEST guidelines. For patients with VTE and no cancer, long-term (3 months) therapy is recommended with one of the newer oral anticoagulants (dabigatran, rivaroxaban, apixaban, or edoxaban) over vitamin K antagonists such as warfarin. But warfarin is recommended over low molecular weight heparin (LMWH). For VTE and cancer, LMWH is still the first choice. For deep venous thrombosis (DVT), compression stockings are not routinely recommended to treat post-thrombotic syndrome. Low-risk subsegmental pulmonary embolism without proximal DVT may be monitored without anticoagulation, although patients should be anticoagulated if they have a high risk of VTE. (Chest 2016;149:315-352. doi:10.1016/j.chest.2015.11.026)
The guideline contains some significant changes from the previous CHEST guidelines.
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