ReviewAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2023
Management of Gastrointestinal Bleeding and Resumption of Oral Anticoagulant Therapy in Patients with Atrial Fibrillation: A Multidisciplinary Discussion.
Review in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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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
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Direct Oral Anticoagulants Versus Vitamin K Antagonists in Cerebral Venous Thrombosis: A Systematic Review and Meta-Analysis of 4,929 Patients.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Patterns of deprescribing after an emergency department visit due to adverse drug events among concomitant users of antithrombotics and other medications.medRxiv : the preprint server for health sciences · 2026Article
- Predictors and Outcomes of Nonvariceal Upper Gastrointestinal Bleed After Coronary Artery Bypass Grafting: A Nationwide Analysis.Journal of the American Heart Association · 2026Article
- Characteristics, Risk Stratification, and Outcomes of Upper Gastrointestinal Bleeding in Patients Receiving Antithrombotic Therapy.Biomedicines · 2026Article
- Association between atrial fibrillation and gastrointestinal bleeding: pathophysiology, risk stratification, and management - a narrative review.Annals of medicine and surgery (2012) · 2026Review
- Intelligent mobile health management for the risk of gastrointestinal bleeding in anticoagulated patients with cardiovascular disease.Revista da Escola de Enfermagem da U S P · 2026Observational
- Brazilian Atrial Fibrillation Guidelines - 2025.Arquivos brasileiros de cardiologia · 2025Article
- The Relationship Between Blood Parameters and Gastrointestinal Bleeding in Atrial Fibrillation Patients Receiving Oral Anticoagulants.Journal of clinical medicine · 2025Article
- Article
- Risk factors and predictive model for gastrointestinal bleeding in patients with ischemic stroke: a case-control study.American journal of translational research · 2025Article
- Delphi consensus statement for the management of delayed post-polypectomy bleeding.Therapeutic advances in gastroenterology · 2025Article
- Position statement of the Polish Society of Gastroenterology on the use of andexanet alfa in patients with gastrointestinal bleeding taking factor Xa inhibitors.Przeglad gastroenterologiczny · 2025Article
- Article
- Urgent Reversal of Direct Oral Anticoagulants in Critical and Life-Threatening Bleeding: A Multidisciplinary Expert Consensus.Journal of clinical medicine · 2024Review
- Management of Patients Receiving Anticoagulation Therapy in Dental Practice: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Coagulation Tests and Reversal Agents in Patients Treated with Oral Anticoagulants: The Challenging Scenarios of Life-Threatening Bleeding and Unplanned Invasive Procedures.Journal of clinical medicine · 2024Review
- Narrative Review of Management Strategies and Risk Mitigation for Gastrointestinal Bleeding in Atrial Fibrillation Patients Receiving Warfarin.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Direct oral anticoagulants (DOACs) are recommended for the prevention of thromboembolism in patients with atrial fibrillation (AF), and are now preferred over vitamin K antagonists due to their beneficial efficacy and safety profile. However, all oral anticoagulants carry a risk of gastrointestinal (GI) bleeding. Although the risk is well documented and acute bleeding well codified, there is limited high-quality evidence and no guidelines to guide physicians on the optimal management of anticoagulation after a GI bleeding event. The aim of this review is to provide a multidisciplinary critical discussion of the optimal management of GI bleeding in patients with AF receiving oral anticoagulants to help physicians provide individualized treatment for each patient and optimize outcomes. It is important to perform endoscopy when a patient presents with bleeding manifestations or hemodynamic instability to determine the bleed location and severity of bleeding and then perform initial resuscitation. Administration of all anticoagulants and antiplatelets should be stopped and bleeding allowed to resolve with time; however, anticoagulant reversal should be considered for patients who have life-threatening bleeding or when the bleeding is not controlled by the initial resuscitation. Anticoagulation needs to be timely resumed considering that bleeding risk outweighs thrombotic risk when anticoagulation is resumed early after the bleeding event. To prevent further bleeding, physicians should prescribe anticoagulant therapy with the lowest risk of GI bleeding, avoid medications with GI toxicity, and consider the effect of concomitant medications on potentiating the bleeding risk.
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