Postbleed Blood Thinners up Rebleeding Risk, Lower Death Risk
Key clinical point: Early resumption of antiplatelet agents or anticoagulants after a major gastrointestinal bleeding event is clearly associated with an increased risk of rebleeding, but a decreased risk of death.
Major finding: Rebleeding occurred in 32% of patients who resumed therapy versus none who did not (P = .002), but deaths were higher in those who did not restart therapy (38.1% vs. 12.5%; P = .003).
Data source: Retrospective, observational cohort study of 160 patients who developed GI bleeding while on antiplatelet or anticoagulant therapy.
Disclosures: Dr. Lanas received consulting fees, speaking and teaching fees, other financial support, and grant and research support from Bayer.
EXPERT ANALYSIS FROM DDW 2015
“In those patients with peptic ulcer bleeding, it’s better to just give the antiplatelet therapy soon after the bleeding event or just to not interrupt the aspirin because the morality at 30 days was higher in those who were interrupted,” Dr. Lanas advised. “...I think for the cutoff point to show differences for patients with a worse outcome versus those with a better outcome, you shouldn’t restart anticoagulant therapy before day 15 after the bleeding event.”
Dr. Lanas received consulting fees, speaking and teaching fees, other financial support, and grant and research support from Bayer.
