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Semin Thromb Hemost 2008; 34(8): 762-771
DOI: 10.1055/s-0029-1145258
© Thieme Medical Publishers

Determinants of Bleeding Risk in Patients on Antithrombotic and Antifibrinolytic Drugs

Karina Meijer1 , 2 , Sam Schulman1
  • 1Thrombosis Service, McMaster Clinic, HHS-General Hospital, Hamilton, Ontario, Canada
  • 2Division of Haemostasis, Thrombosis and Rheology, Department of Haematology, University Medical Centre Groningen, Groningen, The Netherlands
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Publikationsverlauf

Publikationsdatum:
12. Februar 2009 (online)

   Lizenzen und Reprints

ABSTRACT

The risk of bleeding associated with antithrombotic and fibrinolytic therapy depends on factors that are specific for the drugs and the patients. In this narrative review, we describe the most important risk factors for bleeding for each class of drugs. Pertinent examples are recent initiation of therapy with vitamin K antagonists, low-molecular-weight heparins, and renal dysfunction, and higher dose of aspirin. However, for every class of drug, there are also examples that are more controversial. Knowledge of these risk factors helps to weigh the risk and benefit in the selection of therapy in individual patients. Moreover, some risk factors can be modified or avoided if they are recognized.

KEYWORDS

Anticoagulant - antifibrinolytic - antiplatelet - bleeding - complications

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Sam SchulmanM.D. Ph.D. 

Thrombosis Service, HHS-General Hospital

237 Barton St. E, Hamilton, ON L8L 2X2, Canada

eMail: schulms@mcmaster.ca