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Risk of Thromboembolism, Recurrent Hemorrhage, and Death After Warfarin Therapy Interruption for Gastrointestinal Tract Bleeding

Risk of Thromboembolism, Recurrent Hemorrhage, and Death After Warfarin Therapy Interruption for... 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Risk of Thromboembolism, Recurrent Hemorrhage, and Death After Warfarin Therapy Interruption for Gastrointestinal Tract Bleeding

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References (22)

Publisher
American Medical Association
Copyright
Copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2012.4261
pmid
22987143
Publisher site
See Article on Publisher Site

Abstract

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

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Oct 22, 2012

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