New VTE Guidelines Released

Venous thromboembolism treatment guidelines released by American College of Chest Physicians

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) The American College of Chest Physicians (CHEST) issued some new guidelines for the treatment of venous thromboembolism (VTE).

VTE is a dangerous and potentially deadly condition that occurs when a blood clot forms in the veins. When the clot forms in a deep vein, usually in the leg, it's known as deep vein thrombosis (DVT). If that clot breaks loose and travels to the lungs, it's known as pulmonary embolism (PE). Together, DVT and PE are referred to as VTE.

Each year, an estimated 10 million cases of VTE occur worldwide. As many as 300,000 related deaths occur in the US alone.

Among the most notable recommendations of the new guidelines was an overall preference for non-vitamin K antagonist oral anticoagulants (NOACs) over warfarin (brand name Coumadin, others) for VTE patients without cancer. According to CHEST experts, NOACs are as effective as warfarin and may be more convenient for both patients and doctors. They are also linked to a lower risk of bleeding.

Other major recommendations include which patients with subsegmental pulmonary embolism (SSPE) should be given anticoagulants and when compression stockings should be used.

Of the 54 recommendations mentioned, 20 were considered strong and none were based on high-quality evidence. Because of this, the authors said more research is still needed.

"This guideline article ... provides the most up-to-date treatment options for patients with VTE," said lead author Clive Kearon, MD, a professor of medicine at McMaster University, in a press release. "The guideline presents stronger recommendations and weaker suggestions for treatment based on the best available evidence, and identifies gaps in our knowledge and areas for future research."

So far, the new guidelines have been endorsed by the American Association for Clinical Chemistry, the American College of Clinical Pharmacy, and the International Society for Thrombosis and Haemostasis, among others.

Review Date: 
January 7, 2016
Last Updated:
January 10, 2016