ACC guides treatment of bleeding with oral anticoagulation

December 4, 2017

(HealthDay)—A decision pathway has been developed to guide management of acute bleeding in patients treated with oral anticoagulants (OACs); the decision pathway was published online Dec. 1 in the Journal of the American College of Cardiology.

Gordon F. Tomaselli, M.D., from the Johns Hopkins School of Medicine in Baltimore, and colleagues reviewed the evidence and developed policy to guide the management of acute bleeding in patients treated with OACs.

The authors provide a clinically applicable conceptual framework to support clinician decision making during of patients with bleeding complications during OAC therapy. In the event of a bleed, the severity should be assessed, and defined as major or non-major. For most patients with , reversal of the OAC is recommended if an agent is available. Local measures to control bleeding should be combined with volume resuscitation in the case of ongoing bleeding and/or hemodynamic instability. Local measures should also be employed for nonmajor bleeds, although routine reversal of the OAC is not recommended for nonmajor bleeds. There is a net clinical benefit to restarting OACs after a bleeding event in most cases; the indication for OACs should be reassessed after a bleeding event. Clinicians should consider timing of reinitiation of anticoagulation, associated risks, and associated benefits.

"The writing committee hopes that this decision helps the multidisciplinary team of clinicians that care for treated with OACs who have bleeding," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Explore further: CYP2C9 variants linked to clinical events in VTE

More information: Abstract/Full Text (subscription or payment may be required)

Related Stories

CYP2C9 variants linked to clinical events in VTE

September 5, 2017
(HealthDay)—For elderly patients treated with vitamin K antagonists for venous thromboembolism (VTE), CYP2C9 variants are associated with any clinical event, according to a study published online Aug. 22 in the Journal ...

Major bleeding risk from drugs similar in elderly

April 17, 2017
(HealthDay)—The risk of major bleeding is similar for older patients with atrial fibrillation taking either antiplatelet or anticoagulant drugs, according to a review published online April 10 in the Journal of Thrombosis ...

Activity decreases bleeding risk from anticoagulation meds

December 4, 2014
(HealthDay)—For elderly patients on anticoagulant therapy, a high level of physical activity is associated with a decreased risk of major bleeding, according to a study published online Nov. 18 in the Journal of Thrombosis ...

Model predicts acute GI bleeding in anticoagulated patients

June 4, 2017
(HealthDay)—For patients taking oral anticoagulants, a new model can predict acute gastrointestinal (GI) bleeding, which is associated with increased risk of all-cause mortality, according to a study published online May ...

Dabigatran superior to warfarin when anticoagulation is resumed after bleeding

December 1, 2016
In the first analysis of how to treat patients on anticoagulants who suffer a major bleeding event, a clinical practice that routinely gives doctors pause, while also evaluating a new drug, University of Pittsburgh researchers ...

Mortality up with spontaneous bleeding after PCI

April 13, 2015
(HealthDay)—For patients undergoing percutaneous coronary intervention (PCI), spontaneous bleeding is associated with increased risk of death, comparable to that associated with myocardial infarction (MI), according to ...

Recommended for you

'Smart stent' detects narrowing of arteries

June 19, 2018
For every three individuals who have had a stent implanted to keep clogged arteries open and prevent a heart attack, at least one will experience restenosis—the renewed narrowing of the artery due to plaque buildup or scarring—which ...

Marriage may protect against heart disease / stroke and associated risk of death

June 18, 2018
Marriage may protect against the development of heart disease/stroke as well as influencing who is more likely to die of it, suggests a pooled analysis of the available data, published online in the journal Heart.

Deaths from cardiac arrest are misclassified, overestimated

June 18, 2018
Forty percent of deaths attributed to cardiac arrest are not sudden or unexpected, and nearly half of the remainder are not arrhythmic—the only situation in which CPR and defibrillators are effective—according to an analysis ...

Tick-borne meat sensitivity linked to heart disease

June 15, 2018
University of Virginia School of Medicine researchers have linked sensitivity to an allergen in red meat—a sensitivity spread by tick bites—with a buildup of fatty plaque in the arteries of the heart. This buildup may ...

Tobacco aside, e-cigarette flavorings may harm blood vessels

June 14, 2018
Flavor additives used in electronic cigarettes and related tobacco products could impair blood vessel function and may be an early indicator of heart damage, according to new laboratory research in Arteriosclerosis, Thrombosis ...

The molecules that energize babies' hearts

June 14, 2018
A metabolic process that provides heart muscle with energy fails to mature in newborns with thickened heart walls, according to a Japan–Canada research team.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.