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Individualised Risk Assessments for Recurrent Venous Thromboembolism: New Frontiers in the Era of Direct Oral Anticoagulants

by 1,2,3,*, 1,2,3 and 1,2,3
1
Northern Health, Epping, VIC 3076, Australia
2
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
3
Australian Centre for Blood Disease, Monash University, Clayton, VIC 3004, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Leigh A. Madden
Received: 30 November 2020 / Revised: 6 January 2021 / Accepted: 12 January 2021 / Published: 15 January 2021
(This article belongs to the Special Issue Cancer Associated Coagulation)
Venous thromboembolism (VTE) is a leading cause of morbidity and mortality and is associated with high recurrence rates. The introduction of direct oral anticoagulants (DOACs) in the 2010s has changed the landscape of VTE management. DOACs have become the preferred anticoagulant therapy for their ease of use, predictable pharmacokinetics, and improved safety profile. Increasingly, guidelines have recommended long term anticoagulation for some indications such as following first unprovoked major VTE, although an objective individualised risk assessment for VTE recurrence remains elusive. The balance of preventing VTE recurrence needs to be weighed against the not insignificant bleeding risk, which is cumulative with prolonged use. Hence, there is a need for an individualised, targeted approach for assessing the risk of VTE recurrence, especially in those patients in whom the balance between benefit and risk of long-term anticoagulation is not clear. Clinical factors alone do not provide the level of discrimination required on an individual level. Laboratory data from global coagulation assays and biomarkers may provide enhanced risk assessment ability and are an active area of research. A review of the prediction models and biomarkers for assessing VTE recurrence risk is provided, with an emphasis on contemporary developments in the era of DOACs and global coagulation assays. View Full-Text
Keywords: venous thromboembolism; recurrent venous thromboembolism; clinical prediction models; global coagulation assays venous thromboembolism; recurrent venous thromboembolism; clinical prediction models; global coagulation assays
MDPI and ACS Style

Wang, J.; Lim, H.Y.; Ho, P. Individualised Risk Assessments for Recurrent Venous Thromboembolism: New Frontiers in the Era of Direct Oral Anticoagulants. Hemato 2021, 2, 64-78. https://0-doi-org.brum.beds.ac.uk/10.3390/hemato2010003

AMA Style

Wang J, Lim HY, Ho P. Individualised Risk Assessments for Recurrent Venous Thromboembolism: New Frontiers in the Era of Direct Oral Anticoagulants. Hemato. 2021; 2(1):64-78. https://0-doi-org.brum.beds.ac.uk/10.3390/hemato2010003

Chicago/Turabian Style

Wang, Julie, Hui Y. Lim, and Prahlad Ho. 2021. "Individualised Risk Assessments for Recurrent Venous Thromboembolism: New Frontiers in the Era of Direct Oral Anticoagulants" Hemato 2, no. 1: 64-78. https://0-doi-org.brum.beds.ac.uk/10.3390/hemato2010003

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