{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T12:24:39Z","timestamp":1775219079236,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Venous thromboembolism (VTE) is a prevalent medical condition with high morbidity, mortality, and associated costs. Anticoagulation remains the main treatment for VTE, though the decision on when, how, and for how long to administer anticoagulants is increasingly complex. This review highlights the different phases of VTE management, with special circumstances for consideration such as antiphospholipid syndrome, coronary artery disease, cancer-associated thrombus, COVID-19, and future anticoagulation options. Anticoagulation management will continue to be a complex decision, applying evidence-based medicine to individual patients with the hope of maximizing effectiveness while minimizing risks.<\/jats:p>","DOI":"10.3390\/jcm13010301","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T03:43:00Z","timestamp":1704426180000},"page":"301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Choice and Duration of Anticoagulation for Venous Thromboembolism"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5670-2472","authenticated-orcid":false,"given":"Aroosa","family":"Malik","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0002-2061","authenticated-orcid":false,"given":"Nghi B.","family":"Ha","sequence":"additional","affiliation":[{"name":"Pharmacy Innovations & Partnerships, University of Michigan, Ann Arbor, MI 48108, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6532-8440","authenticated-orcid":false,"given":"Geoffrey D.","family":"Barnes","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48109, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S495","DOI":"10.1016\/j.amepre.2009.12.017","article-title":"Venous thromboembolism: A public health concern","volume":"38","author":"Beckman","year":"2010","journal-title":"Am. J. Prev. Med."},{"key":"ref_2","unstructured":"CDC (2023, November 06). Data and Statistics on Venous Thromboembolism, Available online: https:\/\/www.cdc.gov\/ncbddd\/dvt\/data.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/jth.13336","article-title":"Categorization of patients as having provoked or unprovoked venous thromboembolism: Guidance from the SSC of ISTH","volume":"14","author":"Kearon","year":"2016","journal-title":"J. Thromb. Haemost."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2142","DOI":"10.1016\/j.jacc.2020.07.070","article-title":"Antithrombotic Management of Venous Thromboembolism: JACC Focus Seminar","volume":"76","author":"Renner","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.1016\/j.chest.2021.07.056","article-title":"Executive Summary: Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report","volume":"160","author":"Stevens","year":"2021","journal-title":"Chest"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vinson, D.R., Ballard, D.W., Huang, J., Reed, M.E., Lin, J.S., Kene, M.V., Sax, D.R., Rauchwerger, A.S., Wang, D.H., and McLachlan, D.I. (2018). MAPLE Investigators of the KP CREST Network. Outpatient Management of Emergency Department Patients with Acute Pulmonary Embolism: Variation, Patient Characteristics, and Outcomes. Ann. Emerg. Med., 72.","DOI":"10.1016\/j.annemergmed.2017.10.022"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4693","DOI":"10.1182\/bloodadvances.2020001830","article-title":"American Society of Hematology 2020 guidelines for management of venous thromboembolism: Treatment of deep vein thrombosis and pulmonary embolism","volume":"4","author":"Ortel","year":"2020","journal-title":"Blood Adv."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1161\/CIRCULATIONAHA.109.925214","article-title":"Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism: The Vienna prediction model","volume":"121","author":"Eichinger","year":"2010","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1503\/cmaj.080493","article-title":"Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy","volume":"179","author":"Rodger","year":"2008","journal-title":"CMAJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1111\/j.1538-7836.2012.04735.x","article-title":"Predicting disease recurrence in patients with previous unprovoked venous thromboembolism: A proposed prediction score (DASH)","volume":"10","author":"Tosetto","year":"2012","journal-title":"J. Thromb. Haemost."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1056\/NEJMoa1007903","article-title":"Oral rivaroxaban for symptomatic venous thromboembolism","volume":"363","author":"Bauersachs","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1056\/NEJMoa1113697","article-title":"Extended use of dabigatran, warfarin, or placebo in venous thromboembolism","volume":"368","author":"Schulman","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1056\/NEJMoa1207541","article-title":"Apixaban for extended treatment of venous thromboembolism","volume":"368","author":"Agnelli","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1056\/NEJMoa1700518","article-title":"Rivaroxaban or aspirin for extended treatment of venous thromboembolism","volume":"376","author":"Weitz","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1200\/JCO.2018.78.8034","article-title":"Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: Results of a randomized trial (SELECT-D)","volume":"36","author":"Young","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/jth.14662","article-title":"Apixaban and dalteparin inactive malignancy-associated venous thromboembolism: The ADAM VTE trial","volume":"18","author":"McBane","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJMoa1915103","article-title":"Apixaban for the treatment of venous thromboembolism associated with cancer","volume":"382","author":"Agnelli","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1182\/bloodadvances.2020003442","article-title":"American Society of Hematology 2021 guidelines for management of venous thromboembolism: Prevention and treatment in patients with cancer","volume":"5","author":"Lyman","year":"2021","journal-title":"Blood Adv."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.thromres.2018.02.144","article-title":"Direct oral anticoagulant (DOAC) versus low-molecular weight heparin (LMWH) for treatment of cancer associated thrombosis (CAT): A systematic review and meta-analysis","volume":"173","author":"Li","year":"2019","journal-title":"Thromb. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1016\/j.jacc.2019.01.017","article-title":"Anticoagulation Strategies in Patients With Cancer: JACC Review Topic of the Week","volume":"73","author":"Mosarla","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jacc.2022.10.008","article-title":"Direct Oral Anticoagulants vs Vitamin K Antagonists in Patients With Antiphospholipid Syndromes: Meta-Analysis of Randomized Trials","volume":"81","author":"Khairani","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e426","DOI":"10.1016\/S2352-3026(16)30079-5","article-title":"Rivaroxaban versus warfarin to treat patients with thrombotic antiphospholipid syndrome, with or without systemic lupus erythematosus (RAPS): A randomised, controlled, open-label, phase 2\/3, non-inferiority trial","volume":"3","author":"Cohen","year":"2016","journal-title":"Lancet Haematol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1182\/blood-2018-04-848333","article-title":"Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome","volume":"132","author":"Pengo","year":"2018","journal-title":"Blood"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"685","DOI":"10.7326\/M19-0291","article-title":"Rivaroxaban versus vitamin K antagonist in antiphospholipid syndrome: A randomized noninferiority trial","volume":"171","author":"Vidal","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1182\/bloodadvances.2021005808","article-title":"Apixaban compared with warfarin to prevent thrombosis in thrombotic antiphospholipid syndrome: A randomized trial","volume":"6","author":"Woller","year":"2022","journal-title":"Blood Adv."},{"key":"ref_27","first-page":"1538","article-title":"Direct oral anticoagulants in patients with venous thromboembolism and thrombophilia: A systematic review and meta-analysis","volume":"17","author":"Elsebaie","year":"2019","journal-title":"J. Thromb. Haemost."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.thromres.2020.07.052","article-title":"Thrombophilia testing in patients receiving rivaroxaban or apixaban for the treatment of venous thromboembolism","volume":"195","author":"Kovacs","year":"2020","journal-title":"Thromb. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1001\/archinternmed.2010.271","article-title":"Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation","volume":"170","author":"Hansen","year":"2010","journal-title":"Arch. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jacc.2020.09.011","article-title":"2020 ACC Expert Consensus Decision Pathway for Anticoagulant and Antiplatelet Therapy in Patients With Atrial Fibrillation or Venous Thromboembolism Undergoing Percutaneous Coronary Intervention or With Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Solution Set Oversight Committee","volume":"77","author":"Kumbhani","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_31","unstructured":"NIH (2023, November 26). Antithrombotic Therapy in Patients with COVID-19, Available online: https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antithrombotic-therapy."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"ATTACC, ACTIV-4a, and REMAP-CAP Investigators (2021). Therapeutic anticoagulation with heparin in noncritically ill patients with COVID-19. N. Engl. J. Med., 385, 790\u2013802.","DOI":"10.1056\/NEJMoa2105911"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"n2400","DOI":"10.1136\/bmj.n2400","article-title":"Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with COVID-19 admitted to hospital: RAPID randomised clinical trial","volume":"375","author":"Sholzberg","year":"2021","journal-title":"BMJ"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1001\/jamainternmed.2021.6203","article-title":"Efficacy and safety of therapeutic-dose heparin vs standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19: The HEP-COVID randomized clinical trial","volume":"181","author":"Spyropoulos","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/j.jacc.2023.02.041","article-title":"Randomized trial of anticoagulation strategies for noncritically ill patients hospitalized with COVID-19","volume":"81","author":"Stone","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1016\/S0140-6736(21)01203-4","article-title":"Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): An open-label, multicentre, randomised, controlled trial","volume":"397","author":"Lopes","year":"2021","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S0140-6736(21)02392-8","article-title":"Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): An open-label, multicentre, randomised, controlled trial","volume":"399","author":"Ramacciotti","year":"2022","journal-title":"Lancet"},{"key":"ref_38","unstructured":"RECOVERY Collaborative Group (2022). Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): A randomised, controlled, open-label, platform trial. Lancet, 399, 143\u2013151."},{"key":"ref_39","unstructured":"(2023, November 26). A Study Comparing Abelacimab to Apixaban in the Treatment of Cancer-associated VTE (ASTER), Available online: https:\/\/www.clinicaltrials.gov\/study\/NCT05171049."},{"key":"ref_40","unstructured":"(2023, November 26). A Study Comparing Abelacimab to Dalteparin in the Treatment of Gastrointestinal\/Genitourinary Cancer and Associated VTE (MAGNOLIA), Available online: https:\/\/www.clinicaltrials.gov\/study\/NCT05171075."},{"key":"ref_41","unstructured":"(2023, November 26). Xisomab 3G3 for the Prevention of Catheter-Associated Thrombosis in Patients with Cancer Receiving Chemotherapy, Available online: https:\/\/clinicaltrials.gov\/study\/NCT04465760."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/1\/301\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:40:13Z","timestamp":1760103613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/1\/301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,4]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13010301"],"URL":"https:\/\/doi.org\/10.3390\/jcm13010301","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,4]]}}}