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When patients with systemic anticoagulation have a gastrointestinal bleed (GIB), their anticoagulant is usually discontinued until the bleeding is resolved. However, few guidelines or data are available on if and when anticoagulation should be restarted after resolution of the bleed.
Investigators at an academic medical center prospectively studied 197 anticoagulated patients who presented with GIB. At the time of hospital discharge, anticoagulation was discontinued in 76 (39%) and was restarted in the others. Patients were followed for 90 days for evidence of a thromboembolic event, GIB, or death.
Seven patients (4%) developed a thromboembolic event; in six, anticoagulation had been discontinued (adjusted hazard ratio, 0.121; 95% confidence …