Long-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous Thromboembolism
Authors: Faizan Khan, Tobias Tritschler, Gregoire Le Gal, Dean A. Fergusson, Marc A. Rodger
Journal: Annals of Internal Medicine (2022)

LettersFebruary 2022Long-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous ThromboembolismFaizan Khan, MSc, Tobias Tritschler, MD, Gregoire Le Gal, MD, PhD, Dean A. Fergusson, PhD, Marc A. Rodger, MDFaizan Khan, MScUniversity of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, Tobias Tritschler, MDInselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Gregoire Le Gal, MD, PhDOttawa Hospital Research Institute, University of Ottawa, and The Ottawa Hospital, Ottawa, Ontario, Canada, Dean A. Fergusson, PhDUniversity of Ottawa, Ottawa Hospital Research Institute, and The Ottawa Hospital, Ottawa, Ontario, Canada, Marc A. Rodger, MDOttawa Hospital Research Institute, Ottawa, Ontario, and McGill University, Montreal, Quebec, CanadaAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0731 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We agree that the risk for major bleeding events is highest shortly after initiation of anticoagulant therapy, particularly in the first 3 months of treatment. However, the patient population of our meta-analysis was composed of those with a first unprovoked venous thromboembolism who had already completed at least 3 to 6 months of initial anticoagulation.Although we acknowledge the concern about potential "depletion of susceptibles bias" (that is, bleeding events becoming less frequent over longer periods of time), results from our meta-analysis do not suggest that is the case. As shown in our analysis among patients receiving extended ... Author, Article, and Disclosure InformationAuthors: Faizan Khan, MSc; Tobias Tritschler, MD; Gregoire Le Gal, MD, PhD; Dean A. Fergusson, PhD; Marc A. Rodger, MDAffiliations: University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, CanadaInselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandOttawa Hospital Research Institute, University of Ottawa, and The Ottawa Hospital, Ottawa, Ontario, CanadaUniversity of Ottawa, Ottawa Hospital Research Institute, and The Ottawa Hospital, Ottawa, Ontario, CanadaOttawa Hospital Research Institute, Ottawa, Ontario, and McGill University, Montreal, Quebec, CanadaDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-1094. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLong-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous Thromboembolism Faizan Khan , Tobias Tritschler , Miriam Kimpton , Philip S. Wells , Clive Kearon , Jeffrey I. Weitz , Harry R. Büller , Gary E. Raskob , Walter Ageno , Francis Couturaud , Paolo Prandoni , Gualtiero Palareti , Cristina Legnani , Paul A. Kyrle , Sabine Eichinger , Lisbeth Eischer , Cecilia Becattini , Giancarlo Agnelli , Maria Cristina Vedovati , Geert-Jan Geersing , Toshihiko Takada , Benilde Cosmi , Drahomir Aujesky , Letizia Marconi , Antonio Palla , Sergio Siragusa , Charlotte A. Bradbury , Sameer Parpia , Ranjeeta Mallick , Anthonie W.A. Lensing , Martin Gebel , Michael A. Grosso , Kednapa Thavorn , Brian Hutton , Gregoire Le Gal , Dean A. Fergusson , and Marc A. Rodger , for the MAJESTIC CollaboratorsLong-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous Thromboembolism Philippe Brouillard and Jacques LeLorier Metrics Cited byComparison of Presentation, Treatment, and Outcomes of Venous Thromboembolism in Long-Term Immobile Patients Based on AgeRisk of Recurrent Venous Thromboembolism in Selected Subgroups of Men: A Danish Nationwide Cohort StudyLong‐term risk of recurrent venous thromboembolism among patients receiving extended oral anticoagulant therapy for first unprovoked venous thromboembolism: A systematic review and meta‐analysis February 2022Volume 175, Issue 2Page: W14KeywordsAnticoagulantsHemorrhageRisk assessmentsSystematic reviewsVenous thromboembolism ePublished: 15 February 2022 Issue Published: February 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...