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There are no guidelines for prescribing anticoagulants in patients with competing risks for bleeding and thrombosis. A risk-assessment score might assist clinicians in making decisions about continuing anticoagulant therapy in patients with severe thrombocytopenia.
To determine the factors predisposing patients with immune thrombocytopenia (ITP) to bleeding and thrombosis, Canadian investigators conducted a prospective, longitudinal study using data from the McMaster ITP Registry on 13 patients (mean age, 74 years) with platelet counts <50,000/μL who were receiving anticoagulant therapy for atrial fibrillation (6 patients) or venous thrombosis (7 patients).
During a median follow-up period of 9 months, 10 patients developed more-severe thromb…