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    • Should anticoagulants...

    Should anticoagulants be restarted after GI bleeding or not?

    Written by Dr. Kamal Kant Kohli Kohli Published On 2019-11-05T20:20:42+05:30  |  Updated On 5 Nov 2019 8:20 PM IST
    Should anticoagulants be restarted after GI bleeding or not?






    Patients with gastrointestinal bleeding during anticoagulant and/or antiplatelet therapy represent a clinical challenge.

    Gastrointestinal bleeding is a common side effect of many blood-thinning medications. A new Mayo Clinic research finds that risk is amplified in patients receiving more than one blood thinner – especially if they’re 75 or older. A usual query raised is that should blood thinning medicines be started after an episode of G I bleeding keeping in mind the risk benefit ratio.




    Patients who restart theirblood thinners after a gastrointestinal bleed have a lower risk for dying within the next two years even though they have a higher risk for recurrent gastrointestinal bleeding, according to a study recently published in Alimentary Pharmacology and Therapeutics.





    Carlos Sostres, M.D., from the Hospital Clínico Universitario Lozano Blesa in Zaragoza, Spain, and colleagues conducted a study to determine the risk and rates of rebleeding, vascular events and death in patients treated with antiplatelet or anticoagulant agents who developed major gastrointestinal bleeding


    The researchers found that among 871 patients (mean age, 78.9 years), 38.9 percent used an anticoagulant agent, 52.5 percent used an antiplatelet agent, and 8.6 percent used both. The vast majority (93.1 percent) interrupted treatment after gastrointestinal bleeding, but 80.5 percent restarted therapy within 7.6 days. During a median follow-up of 24.9 months, resumption of both therapies was associated with a higher risk for rebleeding, lower risk for ischemic events or death, and a similar risk for upper and lower gastrointestinal events. They found a similar pattern of rebleeding with resumption of therapy no more than seven days after bleeding. In patients treated with anticoagulant agents, rebleeding rates were higher than in patients taking antiplatelet agents (138.0 versus 99.0 events per 1,000 patient-years). In 61.8 percent of cases, the rebleeding location was identical.


    The researchers concluded that resumption of anticoagulant or antiplatelet therapy after a gastrointestinal bleeding event was associated with a lower risk of vascular events and death and a higher rebleeding risk. The benefits of early reinstitution of anticoagulant or antiplatelet therapy outweigh the gastrointestinal‐related risks.


    "Our study provides information to balance the risks and benefits of the global management of these two pharmacological groups of drugs widely associated with increased gastrointestinal bleeding risk," the authors write.


    For further reference log on to:

    https://doi.org/10.1111/apt.15441



    Alimentary Pharmacology and Therapeutics.anticoagulantsblood thinnersblood thinning medicinesgastrointestinal bleedingGI bleedingrestarted
    Source : Alimentary Pharmacology and Therapeutics.

    Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2020 Minerva Medical Treatment Pvt Ltd

    Dr. Kamal Kant Kohli Kohli
    Dr. Kamal Kant Kohli Kohli
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