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Question 9#

According to the American College of Chest Physicians, the recommended duration of long-term antithrombotic therapy after provoked DVT is:

A. 2 weeks
B. 1 month
C. 3 months
D. 6 months

Correct Answer is C

Comment:

The recommended duration of antithrombotic therapy is stratified based on whether the DVT was provoked or unprovoked, whether it was the first or a recurrent episode, where the DVT is located, and whether malignancy or thrombophilia is present. In patients with proximal DVT, several randomized clinical trials have demonstrated that shorter-term antithrombotic therapy ( 4 to 6 weeks) is associated with a higher rate ofVTE recurrence than 3 to 6 months of anticoagulation. In these trials, most of the patients with transient risk factors had a low rate of recurrent VTE, and most recurrences were in patients with continuing risk factors. The ACCP recommendation, therefore, is that 3 months of anticoagulation are sufficient to prevent recurrent VTE in patients with DVT occurring around the time of a transient risk factor (e.g., hospitalization, orthopedic or major general surgery).

Summary of American College of Chest Physicians recommendations regarding duration of long-term antithrombotic therapy for deep vein thrombosis (DVT):

LMWH = low molecular weight heparin; VKA = vitamin K antagonist.