Download PDF
Thromb Haemost 2017; 117(09): 1828-1830
DOI: 10.1160/TH16-11-0846
Letter to the Editor
Schattauer GmbH

Consequences of warfarin suspension after major bleeding in very elderly patients with non valvular atrial fibrillation

Giacomo Zoppellaro
1   Cardiology Clinic - Department of Cardiac, Thoracic and Vascular Sciences – University of Padua, Italy
,
Serena Granziera
2   Rehabilitation Ward – Ospedale Classificato “Villa Salus” – Mestre Venice, Italy
,
Giulia Bertozzo
2   Rehabilitation Ward – Ospedale Classificato “Villa Salus” – Mestre Venice, Italy
,
Gentian Denas
1   Cardiology Clinic - Department of Cardiac, Thoracic and Vascular Sciences – University of Padua, Italy
,
Lucia Marigo
3   Geriatric Clinic – Department of Medicine (DIMED) – University of Padua, Italy
,
Florinda Petruzzellis
3   Geriatric Clinic – Department of Medicine (DIMED) – University of Padua, Italy
,
Seena Padayattil Jose
1   Cardiology Clinic - Department of Cardiac, Thoracic and Vascular Sciences – University of Padua, Italy
,
Katia Rossi
3   Geriatric Clinic – Department of Medicine (DIMED) – University of Padua, Italy
,
Giovanni Nante
3   Geriatric Clinic – Department of Medicine (DIMED) – University of Padua, Italy
,
Vittorio Pengo
1   Cardiology Clinic - Department of Cardiac, Thoracic and Vascular Sciences – University of Padua, Italy
› Author Affiliations
Further Information

Publication History

Received: 16 November 2016

Accepted after major revision: 17 May 2017

Publication Date:
10 November 2017 (online)

    Permissions and Reprints

Supplementary Material to this article is available online at www.thrombosis-online.com.

 

  • References

  • 1 Hart RG, Pearce LA, Aguilar MI. Adjusted-dose warfarin versus aspirin for preventing stroke in patients with atrial fibrillation. Ann Intern Med 2007; 147: 590-592.
    PubMedGoogle Scholar
  • 2 Marinigh R, Lip GY, Fiotti N. Age as a risk factor for stroke in atrial fibrillation patients: implications for thromboprophylaxis. J Am Coll Cardiol 2010; 56: 827-837.
    CrossrefPubMedGoogle Scholar
  • 3 Hylek EM, Evans-Molina C, Shea C. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 2007; 115: 2689-2696.
    CrossrefPubMedGoogle Scholar
  • 4 Zoppellaro G, Granziera S, Padayattil JS. Minimizing the risk of hemorrhagic stroke during anticoagulant therapy for atrial fibrillation. Expert Opin Drug Saf 2015; 14: 683-695.
    CrossrefPubMedGoogle Scholar
  • 5 Granziera S, Bertozzo G, Pengo V. To treat or not to treat very elderly naive patients with atrial fibrillation with vitamin K antagonists (VKA): results from the VENPAF cohort. Intern Emerg Med 2015; 10: 795-804.
    CrossrefPubMedGoogle Scholar
  • 6 Bertozzo G, Zoppellaro G, Granziera S. et al. Reasons for and consequences of vitamin K antagonist discontinuation in very elderly patients with non-valvular atrial fibrillation. J Thromb Haemost. 2016 Epub ahead of print
    PubMedGoogle Scholar
  • 7 Mancia G, Fagard R, Narkiewicz K. et al. 2013 ESH/ESC Practice Guidelines for the Management of Arterial Hypertension. Blood Press 2014; 23: 3-16.
    CrossrefPubMedGoogle Scholar
  • 8 McMurray JJ, Adamopoulos S, Anker SD. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33: 1787-1847.
    CrossrefPubMedGoogle Scholar
  • 9 Steiner T, Al-Shahi Salman R, Ntaios G. The European Stroke Organisation (ESO) guidelines. Int J Stroke 2014; 09: 838-839.
    CrossrefPubMedGoogle Scholar
  • 10 Task Force on diabetes p-d, cardiovascular diseases of the European Society of C, European Association for the Study of D. Ryden L, Grant PJ, Anker SD. et al. ESC guidelines on diabetes, prediabetes, and cardiovascular diseases developed in collaboration with the EASD – summary. Diab Vasc Dis Res 2014; 11: 133-173.
    CrossrefPubMedGoogle Scholar
  • 11 Pisters R, Lane DA, Nieuwlaat R. et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093-1100.
    CrossrefPubMedGoogle Scholar
  • 12 Gage BF, Waterman AD, Shannon W. et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. J Am Med Assoc 2001; 285: 2864-2870.
    CrossrefPubMedGoogle Scholar
  • 13 Rosendaal FR, Cannegieter SC, van der Meer FJ, Briet E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 1993; 69: 236-239.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Fang MC, Go AS, Chang Y. et al. Warfarin discontinuation after starting warfarin for atrial fibrillation. Circ Cardiovasc Qual Outcomes 2010; 03: 624-631.
    CrossrefPubMedGoogle Scholar
  • 15 Schulman S, Kearon C. Subcommittee on Control of Anticoagulation of the S, Standardization Committee of the International Society on T, Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 03: 692-694.
    CrossrefPubMedGoogle Scholar
  • 16 Fang MC, Go AS, Hylek EM. et al. Age and the risk of warfarin-associated hemorrhage: the anticoagulation and risk factors in atrial fibrillation study. J Am Geriatr Soc 2006; 54: 1231-1236.
    CrossrefPubMedGoogle Scholar
  • 17 Camacho E, LoPresti MA, Bruce S. et al. The role of age in intracerebral hemorrhages. J Clin Neurosci 2015; 22: 1867-1870.
    CrossrefPubMedGoogle Scholar
  • 18 Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1997; 92: 419-424.
    PubMedGoogle Scholar
  • 19 Fang MC, Go AS, Chang Y. et al. Death and disability from warfarin-associated intracranial and extracranial hemorrhages. Am J Med 2007; 120: 700-705.
    CrossrefPubMedGoogle Scholar
  • 20 Bjorck F, Renlund H, Lip GY. et al. Outcomes in a Warfarin-Treated Population With Atrial Fibrillation. JAMA Cardiol 2016; 01: 172-180.
    CrossrefPubMedGoogle Scholar
  • 21 Ho CW, Ho MH, Chan PH. et al. Ischemic stroke and intracranial hemorrhage with aspirin, dabigatran, and warfarin: impact of quality of anticoagulation control. Stroke 2015; 46: 23-30.
    CrossrefPubMedGoogle Scholar
  • 22 Wallentin L, Yusuf S, Ezekowitz MD. et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 2010; 376: 975-983.
    CrossrefPubMedGoogle Scholar
  • 23 Qureshi W, Mittal C, Patsias I. et al. Restarting anticoagulation and outcomes after major gastrointestinal bleeding in atrial fibrillation. Am J Cardiol 2014; 113: 662-668.
    CrossrefPubMedGoogle Scholar
  • 24 Staerk L, Lip GY, Olesen JB. et al. Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study. Br Med J 2015; 351: h5876.
    PubMedGoogle Scholar
  • 25 Witt DM, Delate T, Garcia DA. et al. Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for gastrointestinal tract bleeding. Arch Intern Med 2012; 172: 1484-1491.
    CrossrefPubMedGoogle Scholar