To the Editor: The recent American College of Chest Physicians conference has recommended more prolonged periods of anticoagulant treatment in patients with venous thromboembolic disease (VTD). (1) For example, it has suggested that patients with a first episode of idiopathic VTD be considered for indefinite anticoagulant treatment. (1) However, the incidence of major hemorrhage is higher in the clinical practice than in clinical trials. (2,3) We studied the outcomes in patients treated with acenocoumarol for more than 6 months in a series of consecutive outpatients with VTD from a rural Spanish area.

We conducted a prospective observational study of 94 consecutive ...