Managing Direct Oral Anticoagulant Use After Gastrointestinal Bleeding

Medical claims data support restarting DOACs within 30 days after GI bleeding.

Restarting warfarin or aspirin in patients after gastrointestinal (GI) bleeding is associated with decreased risk for thromboembolic events and death and thus established as best practice. However, little is known about the benefits versus risks of resuming direct oral anticoagulants (DOACs) in patients with GI bleeding.

In a retrospective analysis of medical claims, researchers examined postdischarge resumption of DOACs and outcomes in approximately 1300 DOAC users hospitalized for a GI bleed. Results were as follows:

Patients who did not resume a DOAC were more likely to be older, have heart failure, or receive blood products or intensive care while hospitalized.
Restarting a DOAC within 30 days was not associated with risk for thromboemboli…

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute