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ACP Journal Club |15 March 2016

Restarting antithrombotics after GI bleeding was linked to better outcomes in patients with AF

Geoffrey D. Barnes, MD, MSc; James D. Douketis, MD

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Staerk L, Lip GY, Olesen JB, et al. Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study. BMJ. 2015 Nov 16;351:h5876. 26572685

Hospitalists:

Cardiology:

Gastroenterology:

Hematol/Thrombo:

Neurology:

In patients with atrial fibrillation (AF) who had gastrointestinal (GI) bleeding while receiving antithrombotics, is restarting antithrombotics associated with mortality, thromboembolism, or bleeding?
Cohort study with linkage of national databases.
Denmark.
4602 adults 30 to 100 years of age who had AF and a first hospitalization for GI bleeding (index event) while receiving single or combined antithrombotic therapy with a vitamin K antagonist, dabigatran, rivaroxaban, aspirin, clopidogrel, prasugrel, or ticagrelor. Exclusion criteria included valvular heart disease, total hip or knee replacement within 8 weeks before hospitalization, or deep venous thrombosis or pulmonary embolism within 6 months before hospitalization. 1193 patients who died or had a thromboembolic event, major bleeding, or recurrent GI bleeding in the 90 days after discharge from the index event (blanking period) were excluded, leaving 3409 patients (mean age 78 y, 55% men) in the study.
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Barnes GD, Douketis JD. Restarting antithrombotics after GI bleeding was linked to better outcomes in patients with AF. Ann Intern Med. ;164:JC33. doi: 10.7326/ACPJC-2016-164-6-033

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Published: Ann Intern Med. 2016;164(6):JC33.

DOI: 10.7326/ACPJC-2016-164-6-033

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2016 American College of Physicians
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