 Within 24 hours from acute PE diagnosis, each treating physician local Investigator will be centrally randomized. Treating physicians local Investigator of the participating Units will call the coordinating centres by phone for randomization. Before randomization, in order to avoid any influence on treatment choice, each treating physician local Investigator should declare in advance which treatment strategy will use for his patient intention-to-treat, i.e. standard treatment with heparin plus vitamin K antagonist standard group or DOACs DOACs group Randomization will be stratified by treatment choice of the local Investigator. Each of two intention-to-treat approaches will be therefore randomized to two arms, i.e. arm 1 or arm 2. 