Bleeding Risk Stratification Models in Deciding on Anticoagulation in Patients With Atrial Fibrillation

Kakar, Puneet; Lane, Deirdre A.; Lip, Gregory Y.H.

doi:10.1378/chest.130.5.1296

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…23 The following risk factors have been identified as increasing the risk of bleeding in patients taking warfarin: increased age, female sex, hypertension, anemia, previous MI, cerebrovascular disease, concomitant use of antiplatelet therapy, history of previous bleeding, and concomitant medication use. 24 Three bleeding risk stratification models have been proposed, 24 but complex algorithms and the need for further prospective validation of these systems means that these schemas are not currently widely used but they may be a useful adjunct in the warfarin prescription decision-making process.…”

mentioning

confidence: 99%

Barriers to Anticoagulation in Patients With Atrial Fibrillation

Lane

Lip

2008

Stroke

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confidence: 99%

Barriers to Anticoagulation in Patients With Atrial Fibrillation

Lane

Lip

2008

Stroke

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“…23 Interestingly, patients with risk factors for stroke were associated with the choice to provide triple therapy, despite the fact that patients who have the greatest risk of stroke often have the greatest risk of bleeding. 24 Lack of antithrombotic therapy is associated with increased mortality and major adverse cardiac events (eg, death, acute myocardial infarction, target lesion revascularization). 25 Observations from the CRUSADE initiative noted that patients with NSTEMI who were receiving long-term warfarin therapy had no higher rates of adverse clinical outcomes, including major bleeding, than patients not on warfarin.…”

Section: Discussionmentioning

confidence: 99%

The Use of Antithrombotic Therapies in the Prevention and Treatment of Arterial and Venous Thrombosis

Arepally

Bauer

Bhatt

et al. 2010

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Arterial and venous thrombosis are serious health threats. Patients with atrial fibrillation (AF), acute coronary syndromes (ACS), and venous thromboembolism (VTE) can reduce their risk of thrombosis through proper anticoagulation. Multiple evidence-based guidelines exist regarding the proper use of antithrombotic therapy, yet previous studies have shown the prevalence of inconsistent practices with respect to guideline recommendations. Here, we describe a survey of 647 practicing physicians and their current beliefs, behaviors, and knowledge surrounding the use of antithrombotic therapies in the treatment of their patients with AF, ACS, and VTE. Results show that while most physicians are confident in their abilities to treat patients with these conditions, specific knowledge of guideline recommendations for the optimal use of antithrombotic agents use is low. In addition, physician concerns over bleeding risks and complicated monitoring procedures associated with antithrombotic use were reported as barriers to their use in patients. Survey results also demonstrated that physicians have little knowledge of investigational antithrombotic agents, but would like education about them. These data suggest a need for education on guideline recommendations regarding the appropriate use of current antithrombotic therapies, as well as a need for information on the potential benefits and limitations of investigational drugs that may be used in the future to manage thrombosis in patients with AF, ACS, and VTE.

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“…The utility of bleeding risk stratification schemes for anticoagulated patients with atrial fibrillation also requires further prospective data. 48 …”

Section: Bleeding Riskmentioning

confidence: 99%