This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their
secondary prevention. The problems of determining the rational duration of
anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016). Particular attention is paid to the effectiveness and safety of new oral
anticoagulants and
acetylsalicylic acid in the context of
secondary prevention of
deep vein thrombosis and
pulmonary embolism. A review and a critical analysis of the EINSTEIN CHOICE study were carried out. The results demonstrated the high efficacy and safety of
rivaroxaban 10 and 20 mg in the frame of prolonged
therapy of venous thromboembolic complications in patients, who completed the standard 6-12-month course of treatment and who do not need further
use therapeutic doses of
anticoagulants. The study demonstrated that the use of
rivaroxaban in both doses for 12 months is characterized by greater efficacy and a similar frequency of occurrence of large and clinically significant
bleeding compared with the intake of 100 mg of
acetylsalicylic acid. The authors attempted to determine rational indications for the application of 10 mg of
rivaroxaban in the frame of prolonged
anticoagulant therapy, which will be possible after making appropriate changes to the official instruction for the drug.