A 44-year-old man with an unprovoked deep vein thrombosis and subsequent pulmonary embolism is found to have a Factor V Leiden mutation on hypercoagulability testing. He is heterozygous for the mutation. He has been on anticoagulation for 6 months. Which of the following best describes the implication of this finding for his long-term management?

  1. A)Anticoagulation can be safely stopped at 6 months because heterozygous Factor V Leiden carries low recurrence risk
  2. B)Test all first-degree relatives and anticoagulate those who are positive
  3. C)Switch to aspirin for lifelong secondary prevention
  4. D)The Factor V Leiden mutation does not affect management decisions for VTE
  5. E)Indefinite anticoagulation is recommended given the combination of unprovoked VTE and thrombophiliaGABARITO

Explicação

Unprovoked VTE in a patient with a confirmed thrombophilia (heterozygous Factor V Leiden) favors indefinite anticoagulation because both the unprovoked nature and the genetic predisposition increase recurrence risk. Current guidelines recommend extended antico... Ver explicação completa e trilha adaptativa →

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