Quick Facts
- 1. Venous thromboembolism: a public health concern. Am J Prev Med. 2010 Apr;38(4 Suppl):S495–501. Crossref, Medline, Google Scholar,
- 2. Blood clots. MedlinePlus. Bethesda, MD, National Library of Medicine. Available at: https://medlineplus.gov/bloodclots.html? Updated
April 21, 2021 . Google Scholar, - 3. Venous thromboembolism in adult hospitalizations—United States, 2007–2009. MMWR Morb Mortal Wkly Rep. 2012;61:401–404. Medline, Google Scholar,
- 4. Heart disease and stroke statistics—2023 update: A report from the American Heart Association. Circulation. 2023 Feb 21;147(8):e93–e621. doi:
10.1161/CIR.0000000000001123 . Epub2023 Jan 25 . Erratum in: Circulation. 2023 Feb 21;147(8):e622. PMID:36695182 . Crossref, Medline, Google Scholar,
Overview
- 1. . Pulmonary embolism and deep vein thrombosis. Lancet. 2012;379(9828):1835–1846. Crossref, Medline, Google Scholar,
- 2. Guidance for the treatment of deep vein thrombosis and pulmonary embolism. J Thromb Thrombolysis. 2016;41(1):32–67. Crossref, Medline, Google Scholar,
- 3. Blood clots. MedlinePlus. Bethesda, MD, National Library of Medicine. Available at: https://medlineplus.gov/bloodclots.html? Updated
April 21, 2021 . Google Scholar,
Patient Presentation
- 1. .
Venous thromboembolism . In:Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8th ed. New York, NY: McGraw-Hill; 2016. http://accessmedicine.mhmedical.com.jerome.stjohns.edu:81/content.aspx?bookid=1658§ionid=109429015. AccessedMarch 10, 2017 . Google Scholar, - 2.
Diagnosis and treatment of venous thromboembolism . In:McKean SC, Ross JJ, Dressler DD,eds. Principles and Practice of Hospital Medicine, 2nd ed. New York, NY: McGraw-Hill; 2017. http://accessmedicine.mhmedical.com.jerome.stjohns.edu:81/content.aspx?bookid=1872§ionid=146990827. AccessedMarch 10, 2017 . Google Scholar,
Treatment Goals
- 1. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2):e152S–e184S. Crossref, Medline, Google Scholar,
- 2. Antithrombotic and thrombolytic therapy for valvular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141:e576S. Crossref, Medline, Google Scholar,
- 3. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;70(2):252–289. doi:
10.1016/j.jacc.2017.03.011 . Crossref, Medline, Google Scholar,
Disease State Management
- 1. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):e195S–e226S. Crossref, Medline, Google Scholar,
- 2. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospitalized medical patients. Blood Adv. 2018;2(22):3198–3225. Crossref, Medline, Google Scholar,
- 3. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020;4(19):4693–4738. Crossref, Medline, Google Scholar,
- 4. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160(6):2247–2259. doi:
10.1016/j.chest.2021.07.056 . Crossref, Medline, Google Scholar, - 5. . Parenteral anticoagulants. Chest. 2012;141(2_suppl):e24S–e43S. Crossref, Medline, Google Scholar,
- 6. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest. 2008 Jun;133(6 Suppl):381S–453S. Crossref, Medline, Google Scholar,
- 7. Arixtra package insert. Morgantown, WV: Mylan Institutional LLC; August 2020. Google Scholar,
- 8. Oral anticoagulant therapy. Chest. 2012;141(2_suppl):e44S–e88S. Crossref, Medline, Google Scholar,
- 9. Use of novel oral anticoagulant agents in venous thromboembolism. Cardiovasc Diagn Ther. 2016 Dec; 6(6):570–581. Crossref, Medline, Google Scholar,
- 10. . Practical management approaches to anticoagulation non-compliance, health literacy, and limited English proficiency in the outpatient clinic setting. J Thromb Thrombolysis. 2011 Apr;31(3):321–325. Crossref, Medline, Google Scholar,
- 11. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis. 2016 Jan;41(1):206–232. Crossref, Medline, Google Scholar,
Medications
- 1. Eliquis package insert. Princeton, NJ: Bristol-Myers Squibb; 2012 Dec. Google Scholar,
- 2. Pradaxa package insert. Ridgefield, CT: Boehringer Ingelheim; 2015 Nov. Google Scholar,
- 3. Savaysa package insert. Parsippany, NJ: Daiichi Sankyo; 2015 Jan. Google Scholar,
- 4. Lovenox package insert. Bridgewater, NJ: Sanofi-aventis; 2013 Oct. Google Scholar,
- 5. . Parenteral Anticoagulants. Chest. 2012;141(2_suppl):e24S–e43S. Crossref, Medline, Google Scholar,
- 6. Arixtra package insert. Morgantown, WV: Mylan Institutional LLC; August 2020. Google Scholar,
- 7. Xarelto package insert. Titusville, NJ: Janssen Pharmaceuticals; 2017 Mar. Google Scholar,
- 8. Coumadin package insert. Princeton, NJ: Bristol-Myers Squibb; 2016 Sept. Google Scholar,
- 9. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2):e152S–e184S. Crossref, Medline, Google Scholar,
Complementary and Integrative Health Approaches (CIHA)
- 1. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with Pycnogenol. Clin Appl Thromb Hemost. 2004;10:373–377. Crossref, Medline, Google Scholar,
- 2. Effects of random allocation to vitamin E supplementation on the occurrence of venous thromboembolism. Report from the Women’s Health Study. Circulation. 2007 Sep 10. Crossref, Google Scholar,
- 3. . Diosmin 600 in adjunction to rivaroxaban reduces the risk of post-thrombotic syndrome after femoropopliteal deep vein thrombosis: results of the RIDILOTT DVT study. Int Angiol. 2020 Oct;39(5):361–371. doi:
10.23736/S0392–9590.20.04356-4 . Epub2020 Apr 29 . PMID:32348101 . Crossref, Medline, Google Scholar, - 4. (2013) A Review of Potential Harmful Interactions between Anticoagulant/Antiplatelet Agents and Chinese Herbal Medicines. PLoS ONE. 2013;8(5):e64255. Crossref, Medline, Google Scholar,
- 5. . Drug and dietary interactions of warfarin and novel oral anticoagulants: an update. J Thromb Thrombolysis. 2011;31(3):326–343. Crossref, Medline, Google Scholar,
Monitoring and Follow-Up
- 1. .
Antiplatelet, anticoagulant, and fibrinolytic drugs . In:Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 19th ed. New York, NY: McGraw-Hill; 2014. http://accessmedicine.mhmedical.com.jerome.stjohns.edu:81/content.aspx?bookid=1130§ionid=79732627. AccessedMarch 20, 2017 . Google Scholar, - 2. .
Principles of antithrombotic therapy . In:Kaushansky K, Lichtman MA, Prchal JT, Levi MM, Press OW, Burns LJ, Caligiuri M. eds. Williams Hematology, 9th ed. New York, NY: McGraw-Hill; 2015. http://accessmedicine.mhmedical.com.jerome.stjohns.edu:81/content.aspx?bookid=1581§ionid=94302933. AccessedOctober 20, 2017 . Google Scholar, - 3. Parenteral Anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2)(suppl):24–43. Crossref, Google Scholar,
- 4. Laboratory and clinical monitoring of direct acting oral anticoagulants: what clinicians need to know. Pharmacotherapy. 2017;37(2):236–248. Crossref, Medline, Google Scholar,
- 5. . Recurrent venous thromboembolism after deep vein thrombosis: incidence and risk factors. Arch Intern Med. 2000 Mar 27;160(6):769–774. Crossref, Medline, Google Scholar,
Practical Clinical Management Tips
- 1. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis. 2016 Jan;41(1):206–232. Crossref, Medline, Google Scholar,
- 2. Practical management of anticoagulation in patient with atrial fibrillation. J Am Coll Cardiol. 2015 Apr 7;65(13):1340–1360. Crossref, Medline, Google Scholar,
- 3. . New oral anticoagulants in practice: pharmacological and practical considerations. Am J Cardiovasc Drugs. 2014 Jun;14(3):175–189. Crossref, Medline, Google Scholar,
- 4. . Transitioning to and from the novel oral anticoagulants: a management strategy for clinicians. J Thromb Thrombolysis. 2014 Apr;37(3):372–379. Crossref, Medline, Google Scholar,
- 5. Oral anticoagulant therapy. Chest. 2012;141(2 suppl):e44S–e88S. Crossref, Medline, Google Scholar,
Pharmacogenomics Implications
- 1. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for pharmacogenetics-guided warfarin dosing: 2017 update. Clin Pharmacol Ther. 2017;102(3):397–404. Crossref, Medline, Google Scholar,
- 2. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for pharmacogenetics-guided warfarin dosing: 2017 update. (2016 data). https://cpicpgx.org/content/guideline/publication/warfarin/2017/warfarin-supplement.pdf. Accessed
June 22, 2018 . Google Scholar, - 3. Warfarin Dosing. WarfarinDosing.org. http://www.warfarindosing.org/Source/Home.aspx. Accessed
June 22, 2018 . Google Scholar, - 4. Use of pharmacogenetic and clinical factors to predict the therapeutic dose of warfarin. Clin Pharmacol Ther. 2008;84:326–331. Crossref, Medline, Google Scholar,
- 5. DailyMed. Warfarin. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=558b7a0d-5490-4c1b-802e-3ab3f1efe760. Accessed
June 22, 2018 . Google Scholar, - 6. A pharmacogenetic versus a clinical algorithm for warfarin dosing. N Engl J Med. 2013;369:2283–2293. Crossref, Medline, Google Scholar,
Cultural Sensitivities and Health Disparities
- 1. Venous thromboembolism: a public health concern. Am J Prev Med. 2010 Apr;38(4 Suppl):S495–501. Crossref, Medline, Google Scholar,
- 2. . Effects of race and ethnicity on the incidence of venous thromboembolism. Thromb Res. 2009;123 Suppl 4:S11–7. doi:
10.1016/S0049-3848(09)70136-7 . Crossref, Medline, Google Scholar, - 3. Eliminating health care disparities with mandatory clinical decision support: the venous thromboembolism (VTE) example. Med Care. 2015 Jan;53(1):18–24. Crossref, Medline, Google Scholar,
- 4. . Review of venous thromboembolism and race: the generalizability of treatment guidelines for high-risk populations. J Thromb Thrombolysis. 2016 Aug;42(2):167–171. Crossref, Medline, Google Scholar,
- 5. . Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity? Journal of Multidisciplinary Healthcare. 2015;8:217–228. Crossref, Medline, Google Scholar,
- 6. Warfarin maintenance dose in older patients: higher average dose and wider dose frequency distribution in patients of African ancestry than those of European ancestry. Blood Cells Mol Dis. 2010;45(1):93–97. Crossref, Medline, Google Scholar,
- 7. Literacy, readability and cultural barriers: critical factors to consider when educating older African Americans about anticoagulation therapy. J Clin Nurs. 2003;12(2):275–282. Crossref, Medline, Google Scholar,
- 8. . Stroke prevention in atrial fibrillation: an Asian perspective. Thromb Haemost. 2014;111:789–797. Crossref, Medline, Google Scholar,
- 9. Eliquis package insert. Princeton, NJ: Bristol-Myers Squibb; 2012 Dec. Google Scholar,
- 10. Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT(2)R(2) score. Chest. 2013;144(5):1555–1563. Crossref, Medline, Google Scholar,
- 11. Patient attitudinal and behavioral factors associated with warfarin non-adherence at outpatient anticoagulation clinics. Int J Behav Med. 2010;17(1):33–42. Crossref, Medline, Google Scholar,
- 12. Risk factors for nonadherence to warfarin: results from the IN-RANGE study. Pharmacoepidemiol Drug Saf. 2008 Sep;17(9):853–860. Crossref, Medline, Google Scholar,
- 13. . Practical management approaches to anticoagulation non-compliance, health literacy, and limited English proficiency in the outpatient clinic setting. J Thromb Thrombolysis. 2011 Apr;31(3):321–325. Crossref, Medline, Google Scholar,
- 14. Implementation of an acute venous thromboembolism clinical pathway reduces healthcare utilization and mitigates health disparities. J Hosp Med. 2014 Jul;9(7):430–435. Crossref, Medline, Google Scholar,
Special Populations
- 1. Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2):e737S–e801S. Crossref, Medline, Google Scholar,
- 2. . Treatment of venous thromboembolism in pediatric patients. Front Pediar. 2017;5:26. Medline, Google Scholar,
- 3. American Society of Hematology 2018 guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv. 2018;2(22):3292–3316. Crossref, Medline, Google Scholar,
- 4. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2):e691S–e736S. Crossref, Medline, Google Scholar,
- 5. The 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–694. doi:
10.1111/jgs.15767 . Crossref, Medline, Google Scholar, - 6. Executive summary: antithrombotic therapy for VTE disease: second update of the CHEST Guideline and Expert Panel Report. Chest. 2021;160(6):2247–2259. doi:
10.1016/j.chest.2021.07.056 . Crossref, Medline, Google Scholar, - 7. American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer. Blood Adv. 2021;5(4):927–974. Crossref, Medline, Google Scholar,
- 8. Use of direct oral anticoagulants in patients with thrombotic antiphospholipid syndrome: guidance from the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. J Thromb Haemost. 2020;18(9):2126–2137. doi:
10.1111/jth.14935 . Crossref, Medline, Google Scholar, - 9. . Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation. J Thromb Haemost. 2021;19(8):1874–1882. doi:
10.1111/jth.15358 . Crossref, Medline, Google Scholar, - 10. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed
December 5, 2022 . Google Scholar,
Interprofessional Collaborative Practice
- 1. . Scope of contemporary pharmacy practice: roles, responsibilities, and functions of pharmacists and pharmacy technicians. J Am Pharm Assoc. 2010;50(2):e25–e69. Google Scholar,