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ORIGINAL INVESTIGATION Risk of Thromboembolism, Recurrent Hemorrhage, and Death After Warfarin Therapy Interruption for Gastrointestinal Tract Bleeding Daniel M. Witt, PharmD, FCCP, BCPS; Thomas Delate, PhD; David A. Garcia, MD; Nathan P. Clark, PharmD; Elaine M. Hylek, MD; Walter Ageno, MD; Francesco Dentali, MD; Mark A. Crowther, MD Background: Patients who not only survive a warfarin- Results: There were 442 patients with warfarin- associated gastrointestinal tract bleeding (GIB) event but associated index GIB included in the analyses. Follow- also have an ongoing risk for thromboembolism present ing the index GIB, 260 patients (58.8%) resumed war- 2 clinical dilemmas: whether and when to resume anti- farin therapy. Warfarin therapy resumption after the index coagulation. The objective of this study was to deter- GIB was associated with a lower adjusted risk for throm- mine the incidence of thrombosis, recurrent GIB, and bosis (hazard ratio [HR], 0.05; 95% CI, 0.01-0.58) and death, as well as the time to resumption of anticoagu- death (HR, 0.31; 95% CI, 0.15-0.62), without signifi- lant therapy, during the 90 days following a GIB event. cantly increasing the risk for recurrent GIB (HR, 1.32; 95% CI, 0.50-3.57). Methods: In this retrospective, cohort study using ad- ministrative and clinical
JAMA Internal Medicine – American Medical Association
Published: Oct 22, 2012
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