News Finding: In this high-risk population, extending anticoagulation beyond 3 to 6 months is associated with a reduction in the risk of recurrence as long as treatment is continued.
Paper Finding: [1] [3] [4] [5] [6] In this high-risk population, extending anticoagulation beyond 3 to 6 months is associated with a reduction in the risk of recurrence as long as treatment is continued.
News Context: In this high-risk population, extending anticoagulation beyond 3 to 6 months is associated with a reduction in the risk of recurrence as long as treatment is continued. After randomization, 4 patients were lost to follow-up, all after month 18, and 1 withdrew due to an adverse event. During the 18-month treatment period, the primary outcome (the composite of recurrent venous thromboembolism or major bleeding at 18 months after randomization) occurred in 6 of 184 patients (3 percent) in the warfarin group and in 25 of 187 patients (13.5 percent) in the placebo group, resulting in a relative risk reduction of 78 percent in favor of warfarin.
Paper Context: W hen anticoagulant therapy is stopped after 3 to 6 months of treatment, patients with a first episode of unprovoked venous thromboembolism have a much higher risk of recurrence than those with venous thromboembolism provoked by a transient risk factor (eg, surgery). [1] [3] [4] [5] [6] In this high-risk population, extending anticoagulation beyond 3 to 6 months is associated with a reduction in the risk of recurrence as long as treatment is continued. 9 Because the casefatality rate of recurrent venous thromboembolism is approximately 4-fold higher after pulmonary embolism than after proximal deep-vein thrombosis, 15 the benefit-risk ratio of extended anticoagulation is likely to differ between these 2 types of events, and thus should be evaluated separately.