New anticoagulants
Advances in drug design and an improved understanding of the molecular process of coagulation has transformed anticoagulant drug discovery. This is perhaps the most exciting era to be involved in anticoagulation with the development of new oral compounds that have the potential to change and improve thrombosis care.
Outpatient management of VTE
In the same way that DVT is now largely managed in the outpatient setting, there is much interest in the possibility of extending outpatient management to selected low-risk PE patients. Recently the Pulmonary Embolism Severity Index (PESI) has been shown to predict patients at low risk of adverse outcomes who may be suitable for outpatient care.
Computerised VTE risk assessment
Computer programmes that routinely scan electronic records of hospitalised patients, identifying those likely to benefit from thromboprophylaxis and alerting the attending doctor have found favour in the United States. This form of risk alert has been shown to increase the use of thromboprophylaxis and to improve clinical outcome and a marked reduction in the rate of VTE.
Laboratory predictors of VTE recurrence
There has been growing interest in the role for biomarkers in the risk stratification of patients following a first VTE to predict recurrent events. The identification of patients at high risk may enable tailored treatment to prevent such recurrences.
