Patients with an initial VTE event are at an increased risk for recurrence, but the risk is not equivalent in all patients. Currently available anticoagulation therapies are effective in reducing VTE recurrence, they are associated with bleeding risks.
When assessing the need for and duration of secondary prophylaxis the risk for recurrence needs to be balanced with the risk for bleeding. Warfarin is the most widely used oral anticoagulation agent but is inconvenient in the setting of long-term prophylaxis as it requires frequent monitoring and dose adjustments.
New oral anticoagulant agents can be given in fixed doses without the need for coagulation monitoring hold the promise of being more convenient for secondary prophylaxis.