#ISTH 2022 OAC and bleeding with @DebSiegal Great start highlighting the framework for preventing bleeding upfront at initiation of OAC
And highlights uncertainties in Mx post bleed event
Restarting anticoag post bleed ⬆️Rebleed x2 but ⬇️Death by 40%
Most bleeds are GI but not all GI bleeds are equal
Rebleed is a short and LONG term risk
Studies with VKA suggest restarting within 7days assoc with ⬆️Rebleed risk
Pilot PANTHER study further addresses this area of uncertainty incl assessment of feasibility of a full trial, also incorporating patient preferences
Even More uncertainty re whether to re-start OAC post ICH
Pilot study suggests re-starting OAC ⬆️Rebleed but avoiding OAC ⬆️⬆️ ischemic stroke. Full study underway
If re-starting, waiting 7-8weeks post ICH MIGHT be optimal period to balance rebleed/thrombotic risk
Individualised approach required and beautifully summarised here
If you missed this live, this is another must-watch session for later!
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