Experiences of a low-intensity anticoagulation regimen for extended secondary prevention of XXXX .

@entity1 @entity154 @entity548 @entity2067 @entity1031 @entity1211
Extended treatment with @entity2067 antagonists for more than 6 months is often used for secondary prevention of @entity1211 ( @entity1211 ) in @entity1 at high or moderate risk for recurrent events. The intensity of anticoagulant therapy is usually maintained at an International Normalized Ratio (INR) of 2-3. An INR of 1.5-2 might also prevent @entity1031 with less complications of @entity548 , but results from randomized trials are not yet available. In a non-prospective, uncontrolled study 40 @entity1 with a history of @entity1211 and an estimated high risk for recurrent events due to several previous events and/or @entity154 were, after a median of 11.5 months on regular intensity anticoagulation (INR 2-3), switched to a low intensity regimen (INR 1.5-2). In six of the @entity1 an estimated high risk for complications of @entity548 contributed to this decision. After a median follow-up of 36 months (140 @entity1 -years) recurrent events, complications of @entity548 and some basic quality of life measurements regarding the new treatment were registered. No recurrent events, four minor bleedings and no major bleedings were registered. Twenty-six @entity1 preferred an INR of 1.5-2 compared to 2-3. The main reasons for that preference were a lower risk for @entity548 (13 @entity1 ) and less frequent monitoring of the INR (18 @entity1 ). No @entity1 preferred full-dose anticoagulation at INR 2-3. In @entity1 at a high risk for recurrence of @entity1211 an initial period of regular intensity anticoagulation, followed by a low-intensity regimen, may provide effective and safe secondary prophylaxis.
