HERDOO2 Rule for Discontinuing Anticoagulation in Unprovoked VTE
Identifies low-risk women with unprovoked VTE who can safely discontinue anticoagulation. Not validated in men.
Score interpretation
Women with 0–1 criteria: recurrent VTE about 3 % per patient-year after stopping (REVERSE II).
→ Discuss stopping anticoagulation with the patient; review if new risk factors arise.
Women with 2 or more criteria: high recurrence risk.
→ Continue long-term anticoagulation unless contraindicated.
HERDOO2 does not identify low-risk men; men with unprovoked VTE have a high recurrence risk.
→ Continue long-term anticoagulation unless contraindicated; haematology review.
Interpretation bands for the HERDOO2. Apply clinical judgement and local guidance.
References
- Rodger MA et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ. 2008;179(5):417-426.
- Rodger MA et al. Validating the HERDOO2 rule to guide treatment duration for women with unprovoked venous thrombosis: multinational prospective cohort management study. BMJ. 2017;356:j1065.
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.