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Antithrombotic Guidelines

The CHEST Antithrombotic Guidelines connect you to recommendations for the prevention, diagnosis, and treatment of thrombosis, addressing a comprehensive list of clinical conditions, including medical, surgery, orthopedic surgery, atrial fibrillation, stroke, cardiovascular disease, pregnancy, and neonates and children. 

Individual topics will be updated as new evidence is evaluated.

Updated recommendations are now available for Antithrombotic Therapy for VTE Disease.

Clinician Resources

Education Slide Sets

Slide sets are available for download to incorporate into presentations to share and explain the recommendations from the guidelines.

  • Evidence-Based Management of Anticoagulant Therapy
    Recommendations for the general management of anticoagulant therapy. These slides address initiation, maintenance, dosing, drug interactions, bleeding, and organization of care, offering guidance for many common anticoagulation-related management problems.

  • Prevention of Venous Thromboembolism in Nonsurgical Patients
    Recommendations regarding the decisions in prophylaxis in nonsurgical patients. These slides take into consideration risk factors for both thrombosis and bleeding, clinical context, and patients’ values and preferences. Recommendations incorporate perspectives in bleeding disorders, critical care, preventive medicine, methodology, and cost effectiveness.

  • Prevention of Venous Thromboembolism in Nonorthopedic Surgical Patients
    Recommendations for optimal thromboprophylaxis in nonorthopedic surgical patients. The slides address the risks of venous thromboembolism and bleeding complications, as well as the values and preferences of individual patients.

  • Prevention of Venous Thromboembolism in Orthopedic Surgery Patients
    Recommendations for the optimal strategies for thromboprophylaxis after major orthopedic surgery. Topics covered include pharmacologic and mechanical approaches to reduce patient-important outcomes, such as pulmonary embolism and symptomatic DVT.

  • The Perioperative Management of Antithrombotic Therapy
    Recommendations to simplify patient management and minimize adverse clinical outcomes for perioperative antithrombotic management based on risk assessment for thromboembolism and bleeding.

  • Diagnosis of DVT
    Recommendations for diagnosis of first DVT, including a combined use of pretest probability assessment, D-dimer, and ultrasound.

  • Treatment and Prevention of Heparin-Induced Thrombocytopenia
    Recommendations regarding heparin-induced thrombocytopenia and the primary efficacy outcome measures of interest, including new thrombosis, limb amputation, and major bleeding and death due to thrombosis or bleeding.

  • Antithrombotic Therapy in Atrial Fibrillation
    Recommendations regarding atrial fibrillation based on net clinical benefit for patients at varying levels of stroke risk and in a number of common clinical scenarios.

  • Antithrombotic and Thrombolytic Therapy for Valves
    Recommendations based on the optimal balance of thrombotic and hemorrhagic risk for antithrombotic therapy in valvular disease.

  • Antithrombotic and Thrombolytic Therapy for Ischemic Stroke
    Recommendations for the use of antithrombotic therapy in patients with stroke or transient ischemic attack.

  • The Primary and Secondary Prevention of Cardiovascular Disease
    Recommendations focusing on long-term administration of antithrombotic drugs designed for primary and secondary prevention of cardiovascular disease, including two new antiplatelet therapies (ticagrelor and prasugrel).

  • Antithrombotic Therapy in Peripheral Artery Disease
    Recommendations regarding antithrombotic drug therapies for primary and secondary prevention of cardiovascular disease as well as for the relief of lower-extremity symptoms and critical ischemia in patients with peripheral arterial disease (PAD). The slide set highlights single antiplatelet therapy for primary and secondary prevention of cardiovascular events in most patients with asymptomatic PAD, symptomatic PAD, and asymptomatic carotid stenosis.

  • Venous Thromboembolism, Thrombophilia, Antithrombotic Therapy, and Pregnancy
    Recommendations focusing on the management of venous thromboembolism and thrombophilia. It discusses the use of antithrombotic agents during pregnancy and the associated challenges because of the potential for both fetal and maternal complications.

  • Antithrombotic Therapy in Neonates and Children
    Recommendations focusing on the monitoring to specific target ranges for both unfractionated and low-molecular-weight heparins in neonates and children. It acknowledges the ongoing need for dedicated clinical trials that demonstrate the differences in the pharmacokinetics, dose responses, and monitoring tests for anticoagulation therapy in children compared with adults.



Upon publication of a guideline, CHEST hosts a discussion with the authors to add context and commentary to the issues and challenges facing clinicians. Use as an additional education resource. Learn more.

Patient Education Resources

Education resources are available from the CHEST Foundation to share with your patients. These resources can help educate your patients about clinical information within guidelines. Learn more.