Prophylaxis of venous thromboembolism in Internal Medicine Units: the RAMs issue
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Venous thromboembolism (VTE), i.e., deep venous thrombosis (DVT) and pulmonary embolism (PE), is the third most frequent cardiovascular disorder, and is associated with a considerable disease burden. The prevalence of VTE is increasing with the growing world population and longer life expectancy [1, 2, 3, 4, 5, 6]. Acutely ill hospitalized medical patients—including those with heart failure, severe lung disease, ischaemic stroke, cancer, acute infection, and rheumatologic disease—are at medium–high risk of VTE [1, 2, 3, 4, 5, 6]. Primary pharmacological prophylaxis—begun at the time of admission and continued for the duration of stay in hospital—does not reduce the burden of VTE in such patients, in that it lowers the rate of thrombotic events and VTE-related death, with no effect on total mortality [3, 5, 6]. The net result is an unfavourable risk–benefit ratio at a population level, related, inter alia, to an inappropriate pharmacologic VTE prevention in low-risk patients and its...
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The authors declare that they have no conflict of interest.
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