SynthesisDigestive diseases and sciences2021
Resuming Anticoagulation Following Hospitalization for Gastrointestinal Bleeding Is Associated with Reduced Thromboembolic Events and Improved Mortality: Results from a Systematic Review and Meta-Analysis.
Synthesis in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 7 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 7 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Incidence of and Risk Factors for Repeat Adverse Drug Events: A Systematic Review.Journal of patient safety · 2026Pooled it
- Guideline
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Re-starting anticoagulation and antiplatelets after gastrointestinal bleeding: A systematic review.F1000Research · 2023Pooled it
- Effectiveness and safety of oral anticoagulant therapy in patients with atrial fibrillation with prior gastrointestinal bleeding: A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Guideline
- Guideline
- Review
- Oral anticoagulation in patients with gastrointestinal bleeding and new-onset atrial fibrillation: A population-based registry-linkage study.Journal of internal medicine · 2025Article
- Article
- 2025 Thai guideline for the diagnosis and management of atrial fibrillation.Asian biomedicine : research, reviews and news · 2025Article
- Article
- Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database.Medical sciences (Basel, Switzerland) · 2025Article
- Major bleeding increases the risk of subsequent cardiovascular events in patients with atrial fibrillation: insights from the SAKURA AF registry and RAFFINE registry.Heart and vessels · 2025Article
- Resumption versus discontinuation of direct oral anticoagulation after an episode of gastrointestinal bleeding: a systematic review and meta-analysis of rebleeding episodes.Archives of medical science : AMS · 2025Article
- Look inside the management of colonic diverticular rebleeding: a systematic review.Therapeutic advances in gastroenterology · 2025Review
- Delphi consensus statement for the management of delayed post-polypectomy bleeding.Therapeutic advances in gastroenterology · 2025Article
- Application of Antithrombotic Drugs in Different Age-Group Patients with Upper Gastrointestinal Bleeding.Gastroenterology research and practice · 2024Article
- Direct Oral Anticoagulants in Special Patient Populations.Journal of clinical medicine · 2023Review
- Management of Gastrointestinal Bleeding and Resumption of Oral Anticoagulant Therapy in Patients with Atrial Fibrillation: A Multidisciplinary Discussion.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2023Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSystemic anticoagulants are widely prescribed for prevention and treatment of thromboembolism, but are commonly complicated by gastrointestinal bleeding (GIB). Limited data exist on the management of anticoagulation after hospitalization for GIB and the subsequent risks of recurrent GIB, thromboembolism, and mortality.
methodsWe performed a systematic review and meta-analysis of studies to determine risk of recurrent GIB, thromboembolism, and mortality after resuming anticoagulation following GIB. PubMed, EMBASE, and Scopus were searched for randomized controlled trials and cohort studies in patients with atrial fibrillation, venous thromboembolism, or valvular heart disease who received long-term warfarin or direct oral anticoagulants before experiencing GIB. Studies were included if data were available on anticoagulation management and outcomes of recurrent GIB, thromboembolism, and mortality following GIB.
resultsA total of 5354 studies were reviewed of which 10 were included in the meta-analysis. There were 2080 patients who resumed anticoagulation and 2296 patients who discontinued anticoagulation post-index GIB. Resumption of anticoagulation was associated with a significant increase in recurrent GIB (OR 1.646, 95% CI 1.035-2.617, p = 0.035). There was a significant decrease in thromboembolic events in patients who resumed anticoagulation compared to those who did not (OR 0.340, 95% CI 0.178-0.652, p = 0.001, I
conclusionWhile resumption of anticoagulation following index GIB was associated with a significant increase in recurrent GIB, it was also associated with a significant decrease in thromboembolic events and all-cause mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.