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
