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Unprovoked DVT — RACP Adult Medicine MCQ

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ModerateHaematologyUnprovoked DVTRACP Adult Medicine

A 45-year-old man with unprovoked DVT is started on warfarin. Target INR is 2.0–3.0. After 3 months, he is well. He has no family history of VTE and no identifiable risk factors. Thrombophilia screen (done before anticoagulation) was negative. What is the most appropriate duration of anticoagulation?

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Correct answer: C — Indefinite/lifelong anticoagulation

Unprovoked (idiopathic) DVT has a substantial recurrence risk (approximately 10% per year after stopping). Current guidelines recommend indefinite anticoagulation if bleeding risk is acceptable. The recurrence risk outweighs bleeding risk in most patients. Periodic reassessment of the risk-benefit ratio is essential.

Reference: eTG Haematology – 2024 – VTE Duration; ASH 2020 VTE Guidelines