Question special
Faculty Member

I am curious as to what the authors, faculty members, and residents following this journal club think might change as a result of this study with regards to current clinical practice guideline recommendations for extended VTE therapy in patients not deemed at high risk for bleeding. Currently, the 2016 CHEST guidelines assign these grades for first unprovoked VTE in low risk bleed patients (2B=weak recommendation, moderate level of evidence), recurrent unprovoked VTE in low risk bleed patients (1B=strong recommendation, moderate evidence), and recurrent unprovoked VTE in medium risk bleed patients (2B=weak, moderate evidence). The size of effect demonstrated in this study for rivaroxaban vs. aspirin seems quite substantial in my opinion.