Characterizing anticoagulation reversal practices in Colombia: Initial insights from a national registry

Anticoagulation reversal is critical in emergency settings for patients experiencing anticoagulant-related bleeding or requiring invasive or surgical procedures. Despite its importance, evidence in Colombia is limited. RECCANT-AR ( Re gistro C olombiano de C línicas de Ant icoagulación y el Uso de A gentes R eversores ) is a multicenter, observational, ambispective study analyzing anticoagulated patients requiring reversal therapy due to bleeding or procedural needs. Data from the first 144 patients across four institutions were analyzed to describe their sociodemographic and clinical profiles. The cohort had a mean age of 66.9 years (SD ± 15.3) and a nearly equal sex distribution. Ethnicity was predominantly Mestizo (67.5%), followed by White (17.5%) and Afrodescendant (13.3%). The most common comorbidities were hypertension (61.8%), previous venous thromboembolism episodes (31.3%), dyslipidemia (30.6%), and diabetes mellitus (21.5%). Warfarin was the predominant anticoagulant (84%), followed by apixaban (4.9%) and dabigatran (4.2%). Bleeding was the primary indication for reversal (92.4%), while surgical needs accounted for 7.6% of cases. The most used reversal agents were vitamin K (75%) and prothrombin complex concentrates (27.1%). Hospitalization was required in 82% of cases, with 55.1% admitted to intensive care. The mortality rate was 7.6%. Our study is the first multicenter characterization of anticoagulated patients requiring reversal therapy in Colombia. Cardiovascular comorbidities were highly prevalent. Bleeding was the leading indication for reversal, and warfarin the most used anticoagulant, likely reflecting its higher bleeding risk. Limited availability of direct oral anticoagulant-specific reversal agents remains a challenge. High hospitalization and mortality rates underscore the high-risk nature of this population, emphasizing the need for improved access to reversal agents and optimized anticoagulation practices. Further research is warranted. • First multicenter study on patients requiring anticoagulation reversal in Colombia. • Bleeding was the primary indication for anticoagulation reversal. • Warfarin was the most used anticoagulant, likely reflecting a higher bleeding risk. • Limited availability of DOAC-specific reversal agents remains a challenge. • High hospitalization and mortality rates highlight the high risk of these patients.