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Review: long term anticoagulation reduces recurrent venous thromboembolism

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 Q In patients with venous thromboembolism (VTE), does long term anticoagulation reduce recurrence?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Respirology ★★★★★★☆ Haematology ★★★★★★☆

METHODS

Embedded ImageData sources

PubMed, EMBASE/Excerpta Medica Pharmacology, the Cochrane Central Register of Controlled Trials, clinical trial Web sites of the US government (www.clinicaltrials.gov), and GlaxoSmithKline (http://ctr.glaxowellcome.co.uk) (1969–2004).

Embedded ImageStudy selection and assessment

randomised controlled trials (RCTs) that compared different durations of anticoagulation in patients with VTE, in which initial therapy was similar in both study groups after diagnosis, and recurrent VTE was assessed. Studies that enrolled only high risk patients (such as protein S or C deficiency) were excluded. Study quality was assessed using the 5 point Jadad scale and a quality scale specific for VTE.

Embedded ImageOutcomes

incidence rates of recurrent VTE and major bleeding.

MAIN RESULTS

Analysis was based on a hypothetical model with 4 time points: At time A, …

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