Letter to the Editor

Venous Thromboembolism: Are NOACs the Right Initial Drug of Choice for Unprovoked Venous Thromboembolism?

Authors: Ahmed K. Pasha, MD, Anupa Baral, MD, Muhammad Umer Siddiqui, MD


To the Editor: Venous thromboembolism (VTE) is a common vascular disorder affecting approximately 500,000 people each year in the United States.1 With the advent of novel oral anticoagulants (NOACs), the treatment of VTE has been revolutionized, especially of provoked deep vein thrombosis.2 There remains a concern when VTE is unprovoked when using these agents, however.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Beckman MG, Hooper WC, Critchley SE, et al. Venous thromboembolism: a public health concern. Am J Prev Med 2010;38( 4 suppl ):S495-S501.
2. Coleman CI, Turpie AGG, Bunz TJ, et al. Effectiveness and safety of rivaroxaban versus warfarin in patients with provoked venous thromboembolism. J Thromb Thrombolysis 2018;46:339-345.
3. Skeith L. Anticoagulating patients with high-risk acquired thrombophilias. Blood 2018;132:2219-2229.