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New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients

Extended thromboprophylaxis given to medically ill patients for up to 45 days following an acute hospitalization remains an emerging topic among many hospital-based health care providers. Recent advancements in the field of extended thromboprophylaxis using risk stratification and careful patient se...

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Autores principales: MacDougall, Kira, Spyropoulos, Alex C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230788/
https://www.ncbi.nlm.nih.gov/pubmed/32252423
http://dx.doi.org/10.3390/jcm9041002
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author MacDougall, Kira
Spyropoulos, Alex C
author_facet MacDougall, Kira
Spyropoulos, Alex C
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description Extended thromboprophylaxis given to medically ill patients for up to 45 days following an acute hospitalization remains an emerging topic among many hospital-based health care providers. Recent advancements in the field of extended thromboprophylaxis using risk stratification and careful patient selection criteria have led to an improved safety profile of direct oral anticoagulants (DOACs) and established net clinical benefit when given to key patient subgroups at high risk of venous thromboembolism (VTE) and low risk of bleeding. The Food and Drug Administration (FDA) has now approved the DOACs betrixaban and rivaroxaban for both in-hospital and extended thromboprophylaxis in medically ill patients in these key subgroups, which represents more than one-quarter of hospitalized medically ill patients. This has potential to significantly reduce VTE-related morbidity and mortality for these patients. Emerging data also supports reductions in the risk of arterial thromboembolism in medically ill patients with extended thromboprophylaxis post-hospital discharge using DOACs. This article aims to review the most recent concepts of predicting and preventing VTE and to discuss emerging paradigms of extended thromboprophylaxis in hospitalized medically ill patients utilizing an individualized, risk-adapted approach.
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spelling pubmed-72307882020-05-22 New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients MacDougall, Kira Spyropoulos, Alex C J Clin Med Review Extended thromboprophylaxis given to medically ill patients for up to 45 days following an acute hospitalization remains an emerging topic among many hospital-based health care providers. Recent advancements in the field of extended thromboprophylaxis using risk stratification and careful patient selection criteria have led to an improved safety profile of direct oral anticoagulants (DOACs) and established net clinical benefit when given to key patient subgroups at high risk of venous thromboembolism (VTE) and low risk of bleeding. The Food and Drug Administration (FDA) has now approved the DOACs betrixaban and rivaroxaban for both in-hospital and extended thromboprophylaxis in medically ill patients in these key subgroups, which represents more than one-quarter of hospitalized medically ill patients. This has potential to significantly reduce VTE-related morbidity and mortality for these patients. Emerging data also supports reductions in the risk of arterial thromboembolism in medically ill patients with extended thromboprophylaxis post-hospital discharge using DOACs. This article aims to review the most recent concepts of predicting and preventing VTE and to discuss emerging paradigms of extended thromboprophylaxis in hospitalized medically ill patients utilizing an individualized, risk-adapted approach. MDPI 2020-04-02 /pmc/articles/PMC7230788/ /pubmed/32252423 http://dx.doi.org/10.3390/jcm9041002 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
MacDougall, Kira
Spyropoulos, Alex C
New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients
title New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients
title_full New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients
title_fullStr New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients
title_full_unstemmed New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients
title_short New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients
title_sort new paradigms of extended thromboprophylaxis in medically ill patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230788/
https://www.ncbi.nlm.nih.gov/pubmed/32252423
http://dx.doi.org/10.3390/jcm9041002
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