Long-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous Thromboembolism
Authors: Philippe Brouillard, Jacques LeLorier
Journal: Annals of Internal Medicine (2022)

LettersFebruary 2022Long-Term Risk for Major Bleeding During Extended Oral Anticoagulant Therapy for First Unprovoked Venous ThromboembolismPhilippe Brouillard, MD and Jacques LeLorier, MDPhilippe Brouillard, MDUniversité de Montréal, Montreal, Quebec, CanadaSearch for more papers by this author and Jacques LeLorier, MDUniversité de Montréal, Montreal, Quebec, CanadaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0730 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: In a meta-analysis of randomized clinical trials and prospective cohort studies, Khan and colleagues (1) estimated the bleeding risk for patients receiving direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) for a prolonged period after a first unprovoked venous thromboembolism. As a secondary outcome, they also reported the case-fatality rate for major bleeding events. Among the 17 202 patients included, the authors found a case-fatality rate of major bleeding events of 8.3% (95% CI, 5.1% to 12.2%) for patients receiving VKAs and 9.7% (CI, 3.2% to 19.2%) for patients receiving DOACs. In the Discussion section, the authors ...References1. Khan F, Tritschler T, Kimpton M, et al; MAJESTIC Collaborators. Long-term risk for major bleeding during extended oral anticoagulant therapy for first unprovoked venous thromboembolism. A systematic review and meta-analysis. Ann Intern Med. 2021;174:1420-9. [PMID: 34516270] doi:10.7326/M21-1094 LinkGoogle Scholar2. Linkins LA, Choi PT, Douketis JD. Clinical impact of bleeding in patients taking oral anticoagulant therapy for venous thromboembolism: a meta-analysis. Ann Intern Med. 2003;139:893-900. [PMID: 14644891] LinkGoogle Scholar3. Klok FA, Kooiman J, Huisman MV, et al. Predicting anticoagulant-related bleeding in patients with venous thromboembolism: a clinically oriented review. Eur Respir J. 2015;45:201-10. [PMID: 25102964] doi:10.1183/09031936.00040714 CrossrefMedlineGoogle Scholar4. Goldstein P, Elalamy I, Huber K, et al. Rivaroxaban and other non-vitamin K antagonist oral anticoagulants in the emergency treatment of thromboembolism. Int J Emerg Med. 2013;6:25. [PMID: 23866080] doi:10.1186/1865-1380-6-25 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Philippe Brouillard, MD; Jacques LeLorier, MDAffiliations: Université de Montréal, Montreal, Quebec, CanadaDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L21-0730. 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 Faizan Khan , Tobias Tritschler , Gregoire Le Gal , Dean A. Fergusson , Marc A. Rodger Metrics Cited byLong‐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 ...