Prevention of venous thromboembolism in hospitalized medical patients

The hospitalized medical patient in the US today has multiple risk factors for venous thromboembolism (VTE) and is therefore at a significant risk of developing this condition both during hospitalization and after discharge. The American College of Chest Physicians (ACCP) guidelines recommend pharmacologic prophylaxis unless there are contraindications. Low-molecular-weight heparins (LMWH) are the preferred class of drugs due to multiple advantages, including daily dosing and a decreased risk of heparin-induced thrombocytopenia, to name a few. Several emerging oral anticoagulants, including Factor Xa inhibitors and direct thrombin inhibitors, are currently being evaluated in Phase III clinical trials as prophylaxis against VTE in medically ill patients and may some day replace parenteral drugs.