ArticleHeart (British Cardiac Society)2026
Timing of anticoagulation restart after serious bleeding in atrial fibrillation.
Article in Heart (British Cardiac Society), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Bayesian probabilistic statements for communicating clinical trial results.BMC medicine · 2026Article
- Hemorrhagic Pericardial Effusion and Gastrointestinal Bleed After Atrial Fibrillation Epicardial Ablation: A Case Report.Clinical case reports · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRestarting direct oral anticoagulants (DOACs) after a serious bleeding event in patients with atrial fibrillation (AF) presents a clinical dilemma, with limited evidence on the balance between stroke prevention and recurrent bleeding risk.
methodsUsing nationwide Danish registries (2012-2021), we identified AF patients (Congestive heart failure, Hypertension, Age ≥75 (doubled), Diabetes, Stroke (doubled), Vascular disease, Age 65-74, and Sex category (female) (CHA₂DS₂-VASc score ≥2)) who experienced a first serious bleeding event while on DOAC therapy. Patients were grouped by timing of DOAC restart: within 60 days ('early restarters') vs after 60 days ('late restarters'). HRs for stroke, recurrent bleeding and a composite endpoint (stroke or serious bleeding) were estimated using multivariable Cox models. A secondary analysis examined outcomes across six time-varying antithrombotic treatment regimens.
resultsAmong 10 291 patients who survived 60 days postbleeding, 5970 restarted DOAC early and 4321 later. The early restart group had a lower rate of stroke (HR 0.89; 95% CI 0.74 to 1.08), but the interval includes both moderate benefit and no clear difference, indicating uncertainty in the stroke reduction. Recurrent bleeding was more frequent in early restarters (HR 1.21; 95% CI 1.07 to 1.36). In the time-varying analysis, DOAC monotherapy was associated with reduced stroke risk compared with no treatment (HR 0.78; 95% CI 0.68 to 0.89). However, bleeding risk was also higher during DOAC monotherapy (HR 1.26; 95% CI 1.15 to 1.38).
conclusionsRestarting DOACs early after a serious bleeding event in AF patients may reduce stroke risk but is associated with an increased risk of recurrent bleeding. DOAC monotherapy appears to offer the best stroke protection, though with elevated bleeding risk. These findings highlight the need for individualised decision-making and further trials to define optimal timing for DOAC resumption.
Indexed as
Identifiers
What OpenQuestion holds
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.