Why the study?
Lack of data on balancing bleeding and thrombosis risk creates uncertainty regarding restarting anticoagulants following major bleeding.
Does restarting oral anticoagulation improve net clinical outcomes (composite of thrombosis, bleeding, and death) in patients with factor Xa inhibitor-associated major bleeding?
Population
352 patients enrolled in a prospective factor Xa inhibitor reversal study at 63 centers
Comparison
Restarting oral anticoagulation vs not restarting
Design
Posthoc analysis of a multicenter prospective study
Follow-up
30-day follow-up
Authors
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May support restarting anticoagulation after factor Xa inhibitor major bleeding; leaves open confirmation of net benefit in randomized trials.
Does restarting oral anticoagulation improve net clinical outcomes (composite of thrombosis, bleeding, and death) in patients with factor Xa inhibitor-associated major bleeding?
Restarting anticoagulation after factor Xa inhibitor reversal in major bleeding patients is associated with a net clinical benefit, driven by reduced thrombotic events despite an increased risk of rebleeding.
Milling et al. (2021) studied this question.
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