Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

Scott M Stevens; Scott C Woller; Lisa Baumann Kreuziger; Henri Bounameaux; Kevin Doerschug; Geert-Jan Geersing; Menno V Huisman; Clive Kearon; Christopher S King; Andrew J Knighton; Erica Lake; Susan Murin; Janine R E Vintch; Philip S Wells; Lisa K Moores

doi:10.1016/j.chest.2021.07.055

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Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

Journal article

Open access

Peer reviewed

Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

Scott M Stevens, Scott C Woller, Lisa Baumann Kreuziger, Henri Bounameaux, Kevin Doerschug, Geert-Jan Geersing, Menno V Huisman, Clive Kearon, Christopher S King, Andrew J Knighton, …

Chest, Vol.160(6), pp.e545-e608

12/2021

DOI: 10.1016/j.chest.2021.07.055

PMID: 34352278

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Abstract

This is the 2nd update to the 9th edition of these guidelines. We provide recommendations on 17 PICO (Population, Intervention, Comparator, Outcome) questions, four of which have not been addressed previously. We generate strong and weak recommendations based on high-, moderate-, and low-certainty evidence, using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology. The panel generated 29 guidance statements, 13 of which are graded as strong recommendations, covering aspects of antithrombotic management of VTE from initial management through secondary prevention and risk reduction of postthrombotic syndrome. Four new guidance statements have been added that did not appear in the 9th edition (2012) or 1st update (2016). Eight statements have been substantially modified from the 1st update. New evidence has emerged since 2016 that further informs the standard of care for patients with VTE. Substantial uncertainty remains regarding important management questions, particularly in limited disease and special patient populations.

Anticoagulants - administration & dosage

Anticoagulants - therapeutic use

Antiphospholipid Syndrome - complications

Drug Therapy, Combination

Evidence-Based Medicine

Fibrinolytic Agents - administration & dosage

Fibrinolytic Agents - therapeutic use

Humans

Hypotension - complications

Neoplasms - complications

Pulmonary Embolism - diagnostic imaging

Pulmonary Embolism - drug therapy

Venous Thrombosis - diagnostic imaging

Venous Thrombosis - drug therapy

Details

Title: Subtitle: Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report
Creators: Scott M Stevens - Intermountain Healthcare
Scott C Woller - Intermountain Healthcare
Lisa Baumann Kreuziger - Medical College of Wisconsin
Henri Bounameaux - University of Geneva
Kevin Doerschug - University of Iowa
Geert-Jan Geersing - Utrecht University
Menno V Huisman - Leiden University Medical Center
Clive Kearon - Intermountain Healthcare
Christopher S King - Inova Fairfax Hospital
Andrew J Knighton - Intermountain Healthcare
Erica Lake - Essentia Institute of Rural Health, Duluth, MN
Susan Murin - University of California, Davis
Janine R E Vintch - UCLA Medical Center
Philip S Wells - Ottawa Hospital
Lisa K Moores - Uniformed Services University of the Health Sciences
Resource Type: Journal article
Publication Details: Chest, Vol.160(6), pp.e545-e608
DOI: 10.1016/j.chest.2021.07.055
PMID: 34352278
NLM abbreviation: Chest
ISSN: 0012-3692
eISSN: 1931-3543
Grant note: DOI: 10.13039/100009965, name: American College of Physicians
Language: English
Date published: 12/2021
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Hardin Library; Internal Medicine
Record Identifier: 9984248721002771

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