[Anticoagulant therapy in venous thromboembolism and bleeding risk: focus on the use of predictive scores.]. in Recenti progressi in medicina / Recenti Prog Med. 2024 Sep;115(9):389-396. doi: 10.1701/4334.43177.
2024
ASL Città di Torino
ASL Torino 3
Tipo pubblicazione
Review
Autori/Collaboratori (2)
Cavagna LM
Centro TAO-NAO Multicentro, Laboratorio Analisi Unificato Rivoli-Pinerolo, Asl To 3.
Bazzan M
Referente trombosi ed emostasi Cmid, Ospedale San Giovanni Bosco, Torino.
Abstract
The standard treatment for venous thromboembolism (Vte) is anticoagulation. Drug selection and treatment duration will depend on the clinical presentation, the existence of provoking factors, bleeding risk, and the patient's preferences. Anticoagulation therapy is indicated for 3-6 months in all patients with acute Vte but may be extended, even indefinitely in some cases. The most severe side effect of anticoagulation is bleeding, with the highest risk occurring during the 1st months of therapy. Balancing the risk of bleeding and the risk of recurrence in patients with Vte remain a major issue. There are, currently, no simple and validated predictive scores to estimate the long-term bleeding risk in patients undergoing anticoagulant treatment and to safely select those patients with higher bleeding risk. In this review we will examine some of these scores, including the RIETE scores, the HAS-BLED SCORE, the VTE-BLEED score, the VTE- PREDICT and the ACCP guidelines and the timing for their application in the patient's population treated for Vte as well as the initial and long-term management and evaluation of thromboembolic disease.
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PMID : 39269350
DOI : 10.1701/4334.43177
Keywords
Predictive Value of Tests; Risk Factors; Anticoagulants/adverse effects/administration & dosage; Risk Assessment; Hemorrhage/chemically induced; Venous Thromboembolism/drug therapy; Practice Guidelines as Topic; Humans;