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Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism : A Position Paper from the ESC Working Group on Thrombosis, in collaboration with the European Heart Rhythm Association, the Association for Acute CardioVascular Care and the Asia-Pacific Heart Rhythm Society. / Gorog, Diana; Gue, Ying X.; Chao, Tze-Fan; Fauchier, Laurent; Ferreiro, Jose Luis; Huber, Kurt; Konstantinidis, Stavros V; Lane, Deirdre A; Marin, Francisco; Odgren, Jonas; Potpara, Tatjana; Roldan, Vanessa; Rubboli, Andrea; Sibbing, Dirk; Tse, Hung-Fat; Vilahur, Gemma; Lip, Gregory Y H.

In: EP Eurospace, 22.03.2022.

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Gorog, Diana ; Gue, Ying X. ; Chao, Tze-Fan ; Fauchier, Laurent ; Ferreiro, Jose Luis ; Huber, Kurt ; Konstantinidis, Stavros V ; Lane, Deirdre A ; Marin, Francisco ; Odgren, Jonas ; Potpara, Tatjana ; Roldan, Vanessa ; Rubboli, Andrea ; Sibbing, Dirk ; Tse, Hung-Fat ; Vilahur, Gemma ; Lip, Gregory Y H. / Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism : A Position Paper from the ESC Working Group on Thrombosis, in collaboration with the European Heart Rhythm Association, the Association for Acute CardioVascular Care and the Asia-Pacific Heart Rhythm Society. In: EP Eurospace. 2022.

Bibtex

@article{f8c8429dc7d5426495fd24d25dff05d7,
title = "Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism: A Position Paper from the ESC Working Group on Thrombosis, in collaboration with the European Heart Rhythm Association, the Association for Acute CardioVascular Care and the Asia-Pacific Heart Rhythm Society",
abstract = "Whilst there is a clear clinical benefit of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and venous thromboembolism (VTE) in reducing the risks of thromboembolism, major bleeding events (especially intracranial bleeds) may still occur and be devastating. The decision to initiate and continue anticoagulation is often based on a careful assessment of both the thromboembolism and bleeding risk. The more common and validated bleeding risk factors have been used to formulate bleeding risk stratification scores, but thromboembolism and bleeding risk factors often overlap. Also, many factors that increase bleeding risk are transient and modifiable, such as variable international normalized ratio values, surgical procedures, vascular procedures, or drug-drug and food-drug interactions. Bleeding risk is also not a static 'one off' assessment based on baseline factors but is dynamic, being influenced by ageing, incident comorbidities, and drug therapies. In this Consensus Document, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in patients with AF and VTE, with the view to summarizing 'best practice' when approaching antithrombotic therapy in these patients. We address the epidemiology and size of the problem of bleeding risk in AF and VTE, review established bleeding risk factors, and summarize definitions of bleeding. Patient values and preferences, balancing the risk of bleeding against thromboembolism are reviewed, and the prognostic implications of bleeding are discussed. We propose consensus statements that may help to define evidence gaps and assist in everyday clinical practice.",
author = "Diana Gorog and Gue, {Ying X.} and Tze-Fan Chao and Laurent Fauchier and Ferreiro, {Jose Luis} and Kurt Huber and Konstantinidis, {Stavros V} and Lane, {Deirdre A} and Francisco Marin and Jonas Odgren and Tatjana Potpara and Vanessa Roldan and Andrea Rubboli and Dirk Sibbing and Hung-Fat Tse and Gemma Vilahur and Lip, {Gregory Y H}",
note = "{\textcopyright} The Author(s) 2022. Published on behalf of the European Society of Cardiology. All rights reserved. ",
year = "2022",
month = mar,
day = "22",
doi = "10.1093/europace/euac020",
language = "English",
journal = "EP Eurospace",
issn = "1099-5129",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism

T2 - A Position Paper from the ESC Working Group on Thrombosis, in collaboration with the European Heart Rhythm Association, the Association for Acute CardioVascular Care and the Asia-Pacific Heart Rhythm Society

AU - Gorog, Diana

AU - Gue, Ying X.

AU - Chao, Tze-Fan

AU - Fauchier, Laurent

AU - Ferreiro, Jose Luis

AU - Huber, Kurt

AU - Konstantinidis, Stavros V

AU - Lane, Deirdre A

AU - Marin, Francisco

AU - Odgren, Jonas

AU - Potpara, Tatjana

AU - Roldan, Vanessa

AU - Rubboli, Andrea

AU - Sibbing, Dirk

AU - Tse, Hung-Fat

AU - Vilahur, Gemma

AU - Lip, Gregory Y H

N1 - © The Author(s) 2022. Published on behalf of the European Society of Cardiology. All rights reserved.

PY - 2022/3/22

Y1 - 2022/3/22

N2 - Whilst there is a clear clinical benefit of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and venous thromboembolism (VTE) in reducing the risks of thromboembolism, major bleeding events (especially intracranial bleeds) may still occur and be devastating. The decision to initiate and continue anticoagulation is often based on a careful assessment of both the thromboembolism and bleeding risk. The more common and validated bleeding risk factors have been used to formulate bleeding risk stratification scores, but thromboembolism and bleeding risk factors often overlap. Also, many factors that increase bleeding risk are transient and modifiable, such as variable international normalized ratio values, surgical procedures, vascular procedures, or drug-drug and food-drug interactions. Bleeding risk is also not a static 'one off' assessment based on baseline factors but is dynamic, being influenced by ageing, incident comorbidities, and drug therapies. In this Consensus Document, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in patients with AF and VTE, with the view to summarizing 'best practice' when approaching antithrombotic therapy in these patients. We address the epidemiology and size of the problem of bleeding risk in AF and VTE, review established bleeding risk factors, and summarize definitions of bleeding. Patient values and preferences, balancing the risk of bleeding against thromboembolism are reviewed, and the prognostic implications of bleeding are discussed. We propose consensus statements that may help to define evidence gaps and assist in everyday clinical practice.

AB - Whilst there is a clear clinical benefit of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and venous thromboembolism (VTE) in reducing the risks of thromboembolism, major bleeding events (especially intracranial bleeds) may still occur and be devastating. The decision to initiate and continue anticoagulation is often based on a careful assessment of both the thromboembolism and bleeding risk. The more common and validated bleeding risk factors have been used to formulate bleeding risk stratification scores, but thromboembolism and bleeding risk factors often overlap. Also, many factors that increase bleeding risk are transient and modifiable, such as variable international normalized ratio values, surgical procedures, vascular procedures, or drug-drug and food-drug interactions. Bleeding risk is also not a static 'one off' assessment based on baseline factors but is dynamic, being influenced by ageing, incident comorbidities, and drug therapies. In this Consensus Document, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in patients with AF and VTE, with the view to summarizing 'best practice' when approaching antithrombotic therapy in these patients. We address the epidemiology and size of the problem of bleeding risk in AF and VTE, review established bleeding risk factors, and summarize definitions of bleeding. Patient values and preferences, balancing the risk of bleeding against thromboembolism are reviewed, and the prognostic implications of bleeding are discussed. We propose consensus statements that may help to define evidence gaps and assist in everyday clinical practice.

U2 - 10.1093/europace/euac020

DO - 10.1093/europace/euac020

M3 - Article

JO - EP Eurospace

JF - EP Eurospace

SN - 1099-5129

M1 - euac020

ER -