Table 3.

Recommendations for Secondary Prevention of Thrombotic Events in Patients with Polycythemia Vera

Arterial Events
Stroke and antiplatelet agents	Current guidelines recommend clopidogrel, aspirin, or extended-release dipyridamole firstline, but these agents have not been tested in patients with PV. For most patients, there is no increased benefit associated with the use of clopidogrel combined with aspirin Assess other CV risk factors: diabetes mellitus, hypertension, cholesterol
Cardiac and antiplatelet agents	Aspirin 150 to 325 mg daily may be combined with clopidogrel for 12 months Assess other CV risk factors: diabetes mellitus, hypertension, cholesterol
Venous Events
Deep vein thrombosis/pulmonary embolism	Initial therapy with LMWH is recommended, but duration of therapy is unclear Data are available to guide decision-making regarding LMWH use, aspirin continuation, warfarin transition, and use of oral anticoagulants

CV indicates cardiovascular; LMWH, low-molecular-weight heparin; PV, polycythemia vera.