Executive Summary: 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.2021.07.056

Executive Summary: 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

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: 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.

METHODS: We generate strong and weak recommendations based on high-, moderate-, and low-certainty evidence, using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.

RESULTS: 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.

CONCLUSION: 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.

Original language	English
Pages (from-to)	2247-2259
Number of pages	13
Journal	Chest
Volume	160
Issue number	6
DOIs	https://doi.org/10.1016/j.chest.2021.07.056
Publication status	Published - Dec 2021

Keywords

DVT
antithrombotic therapy
guidelines
pulmonary embolism
thrombosis

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Stevens, S. M., Woller, S. C., Baumann Kreuziger, L., Bounameaux, H., Doerschug, K., Geersing, G.-J., Huisman, M. V., Kearon, C., King, C. S., Knighton, A. J., Lake, E., Murin, S., Vintch, J. R. E., Wells, P. S., & Moores, L. K. (2021). Executive Summary: Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report. Chest, 160(6), 2247-2259. https://doi.org/10.1016/j.chest.2021.07.056

@article{03a2c8c502be4ff88e5db0c6481152ac,

title = "Executive Summary: Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report",

abstract = "BACKGROUND: 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.METHODS: We generate strong and weak recommendations based on high-, moderate-, and low-certainty evidence, using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.RESULTS: 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.CONCLUSION: 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.",

keywords = "DVT, antithrombotic therapy, guidelines, pulmonary embolism, thrombosis",

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

note = "Funding Information: FUNDING/SUPPORT: This guideline was supported solely by internal funds from the American College of Chest Physicians. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = dec,

doi = "10.1016/j.chest.2021.07.056",

language = "English",

volume = "160",

pages = "2247--2259",

journal = "Chest",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "6",

}

Stevens, SM, Woller, SC, Baumann Kreuziger, L, Bounameaux, H, Doerschug, K, Geersing, G-J, Huisman, MV, Kearon, C, King, CS, Knighton, AJ, Lake, E, Murin, S, Vintch, JRE, Wells, PS & Moores, LK 2021, 'Executive Summary: Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report', Chest, vol. 160, no. 6, pp. 2247-2259. https://doi.org/10.1016/j.chest.2021.07.056

TY - JOUR

T1 - Executive Summary

T2 - Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report

AU - Stevens, Scott M

AU - Woller, Scott C

AU - Baumann Kreuziger, Lisa

AU - Bounameaux, Henri

AU - Doerschug, Kevin

AU - Geersing, Geert-Jan

AU - Huisman, Menno V

AU - Kearon, Clive

AU - King, Christopher S

AU - Knighton, Andrew J

AU - Lake, Erica

AU - Murin, Susan

AU - Vintch, Janine R E

AU - Wells, Philip S

AU - Moores, Lisa K

PY - 2021/12

Y1 - 2021/12

N2 - BACKGROUND: 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.METHODS: We generate strong and weak recommendations based on high-, moderate-, and low-certainty evidence, using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.RESULTS: 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.CONCLUSION: 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.

AB - BACKGROUND: 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.METHODS: We generate strong and weak recommendations based on high-, moderate-, and low-certainty evidence, using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.RESULTS: 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.CONCLUSION: 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.

KW - DVT

KW - antithrombotic therapy

KW - guidelines

KW - pulmonary embolism

KW - thrombosis

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U2 - 10.1016/j.chest.2021.07.056

DO - 10.1016/j.chest.2021.07.056

M3 - Article

C2 - 34352279

SN - 0012-3692

VL - 160

SP - 2247

EP - 2259

JO - Chest

JF - Chest

IS - 6

ER -

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

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