Key result
Frailty is linked to ~64% higher in-hospital mortality during major bleeding on antithrombotics.
Why the study?
Bleeding complications in cardiovascular patients on antithrombotic therapy pose a major clinical challenge with limited evidence guiding post-bleeding antithrombotic management.
Cross-Sectional (n=134)
Yes
Odds Ratio: 1.639 (95% CI 1.245–2.158)
p-value: p=<0.001
Real-world data demonstrate that major bleeding in cardiovascular patients on antithrombotics carries a high in-hospital mortality rate (14.9%), and post-bleeding management remains highly heterogeneous with nearly 30% of patients discharged without antithrombotics.
Frailty signals higher mortality after antithrombotic bleeding; leaves open optimal resumption strategies pending prospective data.
Background Bleeding complications in cardiovascular patients receiving antithrombotic therapy pose a major clinical challenge, particularly given the limited evidence guiding antithrombotic management after a bleeding event. This snapshot study aimed to evaluate the burden of major bleeding events requiring hospitalization and to describe real-world practices in post-bleeding antithrombotic management. Methods The Attica Bleeding Snapshot was a multicenter, cross-sectional observational study conducted from 17–21 February 2025 in Internal Medicine and Gastroenterology Departments of 17 hospitals in the Attica region, Greece. Adult patients hospitalized for major bleeding while receiving antithrombotic therapy for cardiovascular indications were included. Data collected comprised demographics, comorbidities, antithrombotic regimens, bleeding site, management strategies and in-hospital outcomes. Results Of 1,540 hospitalized patients, 134 (8.7%) experienced major bleeding while on antithrombotic therapy. The mean age was 79.5 ± 11.1 years, and 38.1% were female. Atrial fibrillation (AF) was the most frequent indication for antithrombotic therapy (46.2%), followed by coronary artery disease (20.9%). Gastrointestinal bleeding accounted for 63.5% of cases. In-hospital mortality was 14.9%, with frailty independently associated with mortality (OR 1.639, 95% CI 1.245–2.158, p < 0.001). Approximately one third of patients were discharged without antithrombotic therapy, irrespective of ischemic risk. Conclusion Major bleedings during antithrombotic treatment are associated with substantial morbidity and mortality in cardiovascular patients. Post-bleeding antithrombotic management remains highly heterogeneous, underscoring a critical unmet need. Alternative strategies for thromboembolic prevention, including left atrial appendage occlusion, merit consideration in selected high-risk AF patients, particularly those with recurrent bleeding.
No takes yet. Share an insight, caveat, or question.
Σουλαϊδόπουλος et al. (2026) conducted a cross-sectional in Major bleeding while on antithrombotic therapy for cardiovascular indications (n=134). Antithrombotic therapy was evaluated on In-hospital mortality (and association with frailty score) (OR 1.639, 95% CI 1.245-2.158, p=<0.001). Among cardiovascular patients hospitalized for major bleeding on antithrombotic therapy, in-hospital mortality was 14.9%, with frailty independently associated with mortality (OR 1.64, 95% CI 1.25-2.16, p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: