Recurrent bleeding and thrombotic events after resumption of oral anticoagulants following gastrointestinal bleeding: Communication from the ISTH SSC Subcommittee on Control of Anticoagulation

Review Gastroenterology & Hepatology

Resuming Anticoagulation Following Hospitalization for Gastrointestinal Bleeding Is Associated with Reduced Thromboembolic Events and Improved Mortality: Results from a Systematic Review and Meta-Analysis

Natalie Tapaskar et al.

Summary: Resuming anticoagulation after GIB is associated with increased risk of recurrent GIB, but significantly reduces the risk of thromboembolism and all-cause mortality.

DIGESTIVE DISEASES AND SCIENCES (2021)

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Article Cardiac & Cardiovascular Systems

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

Gerhard Hindricks et al.

EUROPEAN HEART JOURNAL (2021)

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Article Hematology

Management of antithrombotic therapy after gastrointestinal bleeding: A mixed methods study of health-care providers

Derek H. W. Little et al.

Summary: The study revealed that the most important factor influencing provider decision making was re-bleeding risk, followed closely by thrombosis risk, although the indication for OAC was most important for a minority of respondents. This highlights variability among providers in an area lacking high-quality data to guide practice.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2021)

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Article Medicine, General & Internal

Rates of rebleeding, thrombosis and mortality associated with resumption of anticoagulant therapy after anticoagulant-related bleeding

Derek H. W. Little et al.

Summary: This study found that resuming oral anticoagulants after bleeding is associated with a reduction in thrombosis and mortality, but an increase in rebleeding. Randomized controlled trials are needed to evaluate the net benefit of strategies for OAC resumption after a bleeding event.

CANADIAN MEDICAL ASSOCIATION JOURNAL (2021)

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Article Hematology

Novel bleeding risk score for patients with atrial fibrillation on oral anticoagulants, including direct oral anticoagulants

Luise Adam et al.

Summary: This study successfully developed a bleeding risk prediction model for AF patients on oral anticoagulants, with factors such as age over 75 years, history of cancer, prior major hemorrhage, and arterial hypertension included in the final prediction model. The model showed good calibration and discrimination with a Brier score of 0.23 and a c-statistic of 0.71 at 12 months follow-up.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2021)

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Article Hematology

Restart of Anticoagulant Therapy and Risk of Thrombosis, Rebleeding, and Death after Factor Xa Inhibitor Reversal in Major Bleeding Patients

Truman J. Milling et al.

Summary: This study analyzes the relationship between restarting oral anticoagulation after major bleeding and thrombosis, rebleeding, and death. The results suggest that restarting anticoagulation may reduce the risk of thrombotic events but increase the risk of rebleeding. There is modest evidence of net benefit for restarting anticoagulants in these patients.

THROMBOSIS AND HAEMOSTASIS (2021)

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Article Hematology

Bleeding and related mortality with NOACs and VKAs in newly diagnosed atrial fibrillation: results from the GARFIELD-AF registry

Jean-Pierre Bassand et al.

Summary: In patients with atrial fibrillation, NOACs show lower risks of bleeding and all-cause mortality compared to VKAs, with major bleeding associated with the highest risk of death. Minor bleeding and CRNM bleeding are also linked to a higher risk of death compared to no bleeding. A significant percentage of deaths within 30 days after a major bleed are due to intracranial/intraspinal hemorrhage.

BLOOD ADVANCES (2021)

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Article Cardiac & Cardiovascular Systems