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Bleeding in patients on antithrombotics
Background
Overview
Definition
Bleeding in patients on antithrombotics is a common complication in patients treated with both anticoagulation and antiplatelet therapy.
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Pathophysiology
Bleeding in patients on antithrombotics is caused by a complex biological interaction between blood and tissue factors and extensive anticoagulation effect.
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Disease course
The complex biological interaction of blood and tissue factors, in addition to the extensive anticoagulation effect, activates bleeding cascade causing bleeding in patients on antithrombotics, which may be categorized as minor or major bleeding that may increase morbidity and mortality.
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Prognosis and risk of recurrence
Major bleeding is associated with a mortality rate of 11%.
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Guidelines
Key sources
The following summarized guidelines for the management of bleeding in patients on antithrombotics are prepared by our editorial team based on guidelines from the Canadian Cardiovascular Society (CCS 2018) and the British Society for Haematology (BSH 2013).
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Medical management
Patients on UFH: as per BSH 2013 guidelines, discontinue heparin infusions and apply general hemostatic measures to stop bleeding in patients on UFH.
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More topics in this section
Patients on warfarin
Patients on danaparoid
Patients on fondaparinux
Patients on bivalirudin
Patients on argatroban
Patients on dabigatran
Patients on rivaroxaban
Patients on anti-platelets
Patients on fibrinolytics