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American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism.

Publication ,  Journal Article
Ortel, TL; Neumann, I; Ageno, W; Beyth, R; Clark, NP; Cuker, A; Hutten, BA; Jaff, MR; Manja, V; Schulman, S; Thurston, C; Vedantham, S ...
Published in: Blood Adv
October 13, 2020

BACKGROUND: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), occurs in ∼1 to 2 individuals per 1000 each year, corresponding to ∼300 000 to 600 000 events in the United States annually. OBJECTIVE: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support patients, clinicians, and others in decisions about treatment of VTE. METHODS: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and adult patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. RESULTS: The panel agreed on 28 recommendations for the initial management of VTE, primary treatment, secondary prevention, and treatment of recurrent VTE events. CONCLUSIONS: Strong recommendations include the use of thrombolytic therapy for patients with PE and hemodynamic compromise, use of an international normalized ratio (INR) range of 2.0 to 3.0 over a lower INR range for patients with VTE who use a vitamin K antagonist (VKA) for secondary prevention, and use of indefinite anticoagulation for patients with recurrent unprovoked VTE. Conditional recommendations include the preference for home treatment over hospital-based treatment for uncomplicated DVT and PE at low risk for complications and a preference for direct oral anticoagulants over VKA for primary treatment of VTE.

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Published In

Blood Adv

DOI

EISSN

2473-9537

Publication Date

October 13, 2020

Volume

4

Issue

19

Start / End Page

4693 / 4738

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Venous Thromboembolism
  • United States
  • Pulmonary Embolism
  • Humans
  • Hematology
  • Evidence-Based Medicine
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
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Ortel, T. L., Neumann, I., Ageno, W., Beyth, R., Clark, N. P., Cuker, A., … Zhang, Y. (2020). American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv, 4(19), 4693–4738. https://doi.org/10.1182/bloodadvances.2020001830
Ortel, Thomas L., Ignacio Neumann, Walter Ageno, Rebecca Beyth, Nathan P. Clark, Adam Cuker, Barbara A. Hutten, et al. “American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism.Blood Adv 4, no. 19 (October 13, 2020): 4693–4738. https://doi.org/10.1182/bloodadvances.2020001830.
Ortel TL, Neumann I, Ageno W, Beyth R, Clark NP, Cuker A, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020 Oct 13;4(19):4693–738.
Ortel, Thomas L., et al. “American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism.Blood Adv, vol. 4, no. 19, Oct. 2020, pp. 4693–738. Pubmed, doi:10.1182/bloodadvances.2020001830.
Ortel TL, Neumann I, Ageno W, Beyth R, Clark NP, Cuker A, Hutten BA, Jaff MR, Manja V, Schulman S, Thurston C, Vedantham S, Verhamme P, Witt DM, D Florez I, Izcovich A, Nieuwlaat R, Ross S, J Schünemann H, Wiercioch W, Zhang Y. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020 Oct 13;4(19):4693–4738.

Published In

Blood Adv

DOI

EISSN

2473-9537

Publication Date

October 13, 2020

Volume

4

Issue

19

Start / End Page

4693 / 4738

Location

United States

Related Subject Headings

  • Venous Thrombosis
  • Venous Thromboembolism
  • United States
  • Pulmonary Embolism
  • Humans
  • Hematology
  • Evidence-Based Medicine
  • 3201 Cardiovascular medicine and haematology