Long-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous Thromboembolism

2021 ◽  
Author(s):  
Faizan Khan ◽  
Tobias Tritschler ◽  
Miriam Kimpton ◽  
Philip S. Wells ◽  
Clive Kearon ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy

Long-Term Outcomes in Patients Undergoing Coronary Stenting on Dual Oral Antiplatelet Treatment Requiring Oral Anticoagulant Therapy

2008 ◽  
Vol 102 (12) ◽  
pp. 1618-1623 ◽  
Author(s):  
Roberta Rossini ◽  
Giuseppe Musumeci ◽  
Corrado Lettieri ◽  
Maria Molfese ◽  
Laurian Mihalcsik ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Coronary Stenting ◽  
Long Term Outcomes ◽  
Antiplatelet Treatment

scholarly journals Compliance with and awareness about long-term oral anticoagulant therapy among Saudi patients in a University Hospital, Riyadh, Saudi Arabia

2016 ◽  
Vol 7 (1) ◽  
pp. 10 ◽  
Author(s):  
NervanaM. K Bayoumy ◽  
ShehanahFahad Al-Omair ◽  
NorahAhmed Musallam ◽  
NoraYazid Al-Deghaither ◽  
NoufAbdulwahab Al-Sadoun
Keyword(s):  
Saudi Arabia ◽  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
University Hospital ◽  
Saudi Patients

Bleeding complications to long-term oral anticoagulant therapy

1994 ◽  
Vol 1 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Annette Lemche Gull�v ◽  
Birgitte Gade Koefoed ◽  
Palle Petersen
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Bleeding Complications

scholarly journals Risk of major bleeding during extended oral anticoagulation in patients with first unprovoked venous thromboembolism: a systematic review and meta-analysis protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Faizan Khan ◽  
Miriam Kimpton ◽  
Tobias Tritschler ◽  
Grégoire Le Gal ◽  
Brian Hutton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Oral Anticoagulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Bleeding Events ◽  
Major Bleeding Events

Abstract Background The optimal duration of anticoagulation after a first unprovoked venous thromboembolism (VTE) remains controversial. Deciding to stop or continue anticoagulant therapy indefinitely after completing 3 to 6 months of initial treatment requires balancing the long-term risk of recurrent VTE if anticoagulation is stopped against the long-term risk of major bleeding if anticoagulation is continued. However, knowledge of the long-term risk for major bleeding events during extended anticoagulation in this patient population is limited. We plan to conduct a systematic review and meta-analysis to quantify the risk for major bleeding events during extended oral anticoagulation in patients with first unprovoked VTE. Methods Electronic databases including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials will be systematically searched with the assistance of an information specialist (from inception to March 1, 2019) to identify randomized controlled trials and prospective cohort studies reporting major bleeding during extended oral anticoagulation in patients with first unprovoked VTE, who have completed at least 3 months of initial anticoagulant therapy. Study selection, risk of bias assessment, and data extraction will be performed independently by at least two investigators. The number of major bleeding events and person-years of follow-up will be used to calculate the rate (events per 100 person-years) with its 95% confidence interval for each study cohort, during clinically relevant time periods of extended anticoagulant therapy. Results will be pooled using random effect meta-analysis. Discussion The planned systematic review and meta-analysis will provide reliable estimates of the risk for major bleeding events during extended anticoagulation. This information will help inform patient prognosis and assist clinicians with balancing the risks and benefits of treatment to guide management of unprovoked VTE. Systematic review registration PROSPERO CRD42019128597.

scholarly journals Direct Oral Anticoagulants or Standard Anticoagulant Therapy in Fragile Patients with Venous Thromboembolism

TH Open ◽  
2019 ◽  
Vol 03 (01) ◽  
pp. e67-e76 ◽  
Author(s):  
Juan López-Núñez ◽  
Ricard Pérez-Andrés ◽  
Pierpaolo Di Micco ◽  
Sebastian Schellong ◽  
Covadonga Gómez-Cuervo ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Lower Risk ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Term Therapy ◽  
Composite Outcome ◽  
Long Term Therapy

Background The efficacy and safety of the direct oral anticoagulants (DOACs) in fragile patients (age ≥ 75 years and/or creatinine clearance levels ≤ 50 mL/min and/or body weight ≤ 50kg) with venous thromboembolism (VTE) has not been evaluated. Methods We used the RIETE database to compare the rates of the composite of VTE recurrences or major bleeding during anticoagulation in fragile patients with VTE, according to the use of DOACs or standard anticoagulant therapy. Results From January 2013 to April 2018, 24,701 patients were recruited. Of these, 10,054 (41%) were fragile. Initially, 473 fragile patients (4.7%) received DOACs and 8,577 (85%) low-molecular-weight heparin (LMWH). For long-term therapy, 1,298 patients (13%) received DOACs and 5,038 (50%) vitamin K antagonists (VKAs). Overall, 95 patients developed VTE recurrences and 262 had major bleeding. Patients initially receiving DOACs had a lower rate of the composite outcome (hazard ratio [HR]: 0.32; 95% confidence interval [CI]: 0.08–0.88) than those on LMWH. Patients receiving DOACs for long-term therapy had a nonsignificantly lower rate of the composite outcome (HR: 0.70; 95% CI: 0.46–1.03) than those on VKAs. On multivariable analysis, patients initially receiving DOACs had a nonsignificantly lower risk for the composite outcome (HR: 0.36; 95% CI: 0.11–1.15) than those on LMWH, while those receiving DOACs for long-term therapy had a significantly lower risk (HR: 0.61; 95% CI: 0.41–0.92) than those on VKAs. Conclusions Our data suggest that the use of DOACs may be more effective and safe than standard therapy in fragile patients with VTE, a subgroup of patients where the risk for bleeding is particularly high.

Efficacy and Safety of Intravenous Phytonadione (Vitamin K1) in Patients on Long-term Oral Anticoagulant Therapy

2001 ◽  
Vol 76 (3) ◽  
pp. 260-266 ◽  
Author(s):  
Raymond C. Shields ◽  
Robert D. McBane ◽  
James D. Kuiper ◽  
Hongzhe Li ◽  
John A. Heit
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Vitamin K1 ◽  
Efficacy And Safety

P6559Long-term follow-up and outcomes of patients with discontinuation of oral anticoagulant therapy after successful ablation procedures for atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Fujino ◽  
H Yuzawa ◽  
T Kinoshita ◽  
M Shinohara ◽  
H Koike ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Low Risk ◽  
Risk Scores ◽  
Af Ablation ◽  
Successful Ablation

Abstract Background Oral anticoagulant therapy (OAT) is effective for preventing strokes in atrial fibrillation (AF) patients. Currently, there is controversy regarding the discontinuation of OATs in patients with ablation procedures to eliminate AF. Aim We investigated the incidence of major bleeding and ischemic strokes/systemic embolisms in low-risk patients that discontinued OATs after successful AF ablation procedures. Methods Of 330 consecutive patients that underwent AF ablation procedures and were prescribed one of the direct oral anticoagulants or warfarin, 207 AF patients (158 men, mean age 61±11 years) who discontinued OATs three months after the procedure were enrolled. The average CHADS2 and HAS-BLED scores were 1.0±0.9 and 1.2±1.0, respectively, which meant that most patients had a low risk for strokes. Results During follow-up, 31 patients (15%) had recurrences of AF. Those patients underwent a re-ablation procedure and then re-discontinued their OATs three months after the session. During a 60±13 months follow-up, major bleeding was observed in five patients (2.4%) and was associated with a higher HAS-BLED score (2.2±0.4 vs. 1.1±1.0, P=0.027). In contrast, none of the patients experienced ischemic strokes/systemic embolisms. Conclusions This prospective study demonstrated that in patients with successful ablation procedures and low risk scores for AF management, OATs could be discontinued three months after the procedure. Unnecessary continuation of OATs may increase the incidence of major bleeding during the follow-up.

scholarly journals Restarting oral anticoagulant therapy after major bleeding in atrial fibrillation: A systematic review and meta-analysis

2018 ◽  
Vol 261 ◽  
pp. 84-91 ◽  
Author(s):  
Marco Proietti ◽  
Giulio Francesco Romiti ◽  
Imma Romanazzi ◽  
Alessio Farcomeni ◽  
Laila Staerk ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Meta Analysis
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