2023, Number 2
Management of bleeding in patients with anticoagulant therapy
Full text
Language: Spanish
References: 20
Page: 89-100
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ABSTRACT
Anticoagulant therapy, which includes vitamin K antagonists, direct acting oral anticoagulants, as well as heparin, are associated with distinct major hemorrhage rates. As these drugs are increasingly prescribed, they imply an increased acknowledgment among different medical specialties in the management of different clinical scenarios, indications, contraindications, risk factor associated to bleeding, bleeding and thrombosis risk scores, follow up, transition, as well as the management of anticoagulant associated bleeding, and lastly the ideal moment to restart anticoagulation. Here we present a comprehensive review about management of bleeding in anticoagulated patients.REFERENCES
Schulman S, Kearon C; Subcommittee on Control ofAnticoagulation of the Scientific and StandardizationCommittee of the International Society on Thrombosisand Haemostasis. Definition of major bleeding in clinicalinvestigations of antihemostatic medicinal products in nonsurgicalpatients. J Thromb Haemost 2005; 3 (4): 692-4. doi:10.1111/j.1538-7836.2005.01204.x.
Lip GY, Frison L, Halperin JL, Lane DA. Comparative validationof a novel risk score for predicting bleeding risk in anticoagulatedpatients with atrial fibrillation: the HAS-BLED(Hypertension, Abnormal Renal/Liver Function, Stroke,Bleeding History or Predisposition, Labile INR, Elderly,Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol2011; 57 (2): 173-80. doi: 10.1016/j.jacc.2010.09.024.
January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE,Cleveland JC Jr, Ellinor PT, Ezekowitz MD, Field ME, FurieKL, Heidenreich PA, Murray KT, Shea JB, Tracy CM, YancyCW. 2019 AHA/ACC/HRS Focused Update of the 2014AHA/ACC/HRS Guideline for the Management of PatientsWith Atrial Fibrillation: A Report of the American Collegeof Cardiology/American Heart Association Task Force onClinical Practice Guidelines and the Heart Rhythm Society.J Am Coll Cardiol 2019; 74 (1): 104-132. doi: 10.1016/j.jacc.2019.01.011.
10.1016/j.tcm.2019.03.004.10. Schulman S, Angerås U, Bergqvist D, Eriksson B, Lassen MR,Fisher W; Subcommittee on Control of Anticoagulationof the Scientific and Standardization Committee of theInternational Society on Thrombosis and Haemostasis.Definition of major bleeding in clinical investigations ofantihemostatic medicinal products in surgical patients. JThromb Haemost 2010; 8 (1): 202-4. doi: 10.1111/j.1538-7836.2009.03678.x.
Sarode R, Milling TJ Jr, Refaai MA, Mangione A, SchneiderA, Durn BL, Goldstein JN. Efficacy and safety of a 4-factorprothrombin complex concentrate in patients on vitamin Kantagonists presenting with major bleeding: a randomized,plasma-controlled, phase IIIb study. Circulation 2013; 128(11): 1234-43. doi: 10.1161/CIRCULATIONAHA.113.002283.
Pollack CV Jr, Reilly PA, van Ryn J, Eikelboom JW, GlundS, Bernstein RA, Dubiel R, Huisman MV, Hylek EM, KamCW, Kamphuisen PW, Kreuzer J, Levy JH, Royle G, SellkeFW, Stangier J, Steiner T, Verhamme P, Wang B, Young L,Weitz JI. Idarucizumab for dabigatran reversal - full cohortanalysis. N Engl J Med 2017; 377 (5): 431-441. doi: 10.1056/NEJMoa1707278.
Connolly SJ, Crowther M, Eikelboom JW, Gibson CM, CurnutteJT, Lawrence JH, Yue P, Bronson MD, Lu G, Conley PB,Verhamme P, Schmidt J, Middeldorp S, Cohen AT, Beyer-Westendorf J, Albaladejo P, Lopez-Sendon J, Demchuk AM,Pallin DJ, Concha M, Goodman S, Leeds J, Souza S, SiegalDM, Zotova E, Meeks B, Ahmad S, Nakamya J, Milling TJ Jr;ANNEXA-4 Investigators. Full Study Report of AndexanetAlfa for Bleeding Associated with Factor Xa Inhibitors.N Engl J Med 2019; 380 (14): 1326-1335. doi: 10.1056/NEJMoa1814051.