The American College of Chest Physicians Has Placed The 2021 Guidelines Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report behind a paywall!

The American College of Chest Physicians has placed Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report behind a paywall! [PubMed Abstract]. Chest. 2021 Aug 2;S0012-3692(21)01506-3.

So instead, here is the link to PRIMARY CARE-American College of Chest Physicians Guideline on Antithrombotic Therapy for VTE Disease from ObG Project accessed 11-26-2021.

All that follows is from the ObG Project article above. Please review the complete article by clicking on the article.

SUMMARY:
The decision whether to prescribe anticoagulation (AC) for deep vein thrombosis (DVT) or pulmonary embolism (PE), and for what duration, is a highly individualized one that must take into account several clinical variables as well as patient preferences. Recommendations for AC are tailored based on a patient’s bleeding risk profile, characteristics of DVT (proximal vs. distal) and the clinical context in which VTE has occurred (provoked by a major transient risk factor present within 3 months of VTE, provoked by minor transient risk factor within 2 months of diagnosis, provoked by a persistent risk factor, or unprovoked). The American College of Chest Physicians offers a comprehensive evidence-based guideline on how and when to treat VTE with anticoagulation. The new guideline statement also provides guidance based on phase of management

KEY POINTS:

• Treatment phase for acute VTE should last 3 months
• Extended-phase anticoagulation treatment is not needed if risk factors are transient
• Aspirin is not a reasonable alternative to therapy however is reasonable for prevention of recurrent VTE after completion of therapy
• Patients selected to receive extended phase therapy should be offered a reduced dose over full dose of apixaban or rivaroxaban over aspirin or no therapy
• Consider thrombolytic therapy in patients with a PE that are hemodynamically unstable
• Previous scenarios where anticoagulation was not recommended, such as superficial DVTs, may warrant a shorter duration of anticoagulation therapy for 45 days based on risk factors for progression of thrombus

Learn More – Primary Sources

Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report – Executive Summary – CHEST (chestnet.org)