Abstract
Anticoagulant therapy reduces deaths and disability in patients with or at risk of
both arterial and venous thromboembolism. Highly effective antithrombotic therapies
now exist that reduce the risk of both arterial thrombosis and venous thrombosis.
Anticoagulant strategies include platelet inhibition, using a variety of potent platelet
inhibitors, and antithrombotic therapy, designed to interfere with thrombosis by blocking
activation of the coagulation cascade. All anticoagulants increase the risk of bleeding.
Older antithrombotic agents have, in most cases, effective antidotes and well-developed
(although perhaps not very evidence-based) treatment strategies. Newer anticoagulants,
and most antiplatelet drugs, do not have effective antidotes or well-tested reversal
strategies. This narrative review will provide advice on the diagnosis and management
of anticoagulant bleeding with a particular focus on the antithrombotic drugs, including
warfarin, heparin, and the novel agents.
Keywords
bleeding - antithrombotic drugs - anticoagulants - antiplatelet drugs
