Updated guidelines released on antithrombotic therapy, thrombosis prevention

The American College of Chest Physicians released updated guidelines last week on antithrombotic therapy and prevention of thrombosis.

The new guidelines are an update of the organization's previous edition, which was published in 2008, and differ in several important ways, according to the authors. For example, the new guidelines adhere to a more rigorous methodological standard for assessing and interpreting study results, attempt to use clinically meaningful end points (when available) to draw conclusions regarding diagnosis and therapy, and report conclusions and recommendations in a form more useful to clinicians. In addition, each panel of experts responsible for developing the guidelines included a practicing clinician who was not involved in research, with the goal of making the recommendations more relevant to routine clinical practice. Input on appropriate resource use was also sought from experts in the field when determining the strength or weakness of recommendations.

The guidelines, which appear as a supplement to the February Chest, cover the following areas of prevention, diagnosis and treatment in extensive detail:

• evidence-based management of anticoagulant therapy;
• prevention of venous thromboembolism (VTE) in nonsurgical patients;
• prevention of VTE in nonorthopedic surgical patients;
• prevention of VTE in orthopedic surgery patients;
• perioperative management of antithrombotic therapy;
• diagnosis of deep venous thrombosis;
• antithrombotic therapy for VTE disease;
• treatment and prevention of heparin-induced thrombocytopenia;
• antithrombotic therapy for atrial fibrillation;
• antithrombotic and thrombolytic therapy for valvular disease;
• antithrombotic and thrombolytic therapy for ischemic stroke;
• primary and secondary prevention of cardiovascular disease;
• antithrombotic therapy in peripheral artery disease;
• VTE, thrombophilia, antithrombotic therapy and pregnancy; and
• antithrombotic therapy in neonates and children.

The guidelines' executive summary, introduction, and explanation of methodology are available free of charge online.