The Bleeding Risk in Antithrombotic Therapies: A Narrative Review

Curr Vasc Pharmacol. 2020;18(3):237-248. doi: 10.2174/1570161117666190212112743.

Abstract

Bleeding represents the most important complication of antithrombotic treatment, including anticoagulant and antiplatelet therapies. A number of scores were proposed to evaluate the risk of bleeding both for anticoagulant and antiplatelet treatment. In the last decade, 5 bleeding risk scores were published for use in atrial fibrillation patients, and 3 scores for patients receiving anticoagulants for venous thromboembolism therapy or prophylaxis. In addition, 3 scores were recently developed to assess inhospital or short-term bleeding risk in patients receiving antiplatelet therapy after Acute Coronary Syndrome (ACS) and Percutaneous Coronary Intervention (PCI). Furthermore, 3 additional scores have focused on long-term bleeding in outpatients receiving dual antiplatelet therapy after PCI. The aim of this review is to consider the evidence on bleeding scores.

Keywords: Bleeding; acute coronary syndrome; anticoagulants; antiplatelet therapy; atrial fibrillation; clinical predictive rules; percutaneous coronary intervention; venous thromboembolism..

Publication types

  • Review

MeSH terms

  • Animals
  • Anticoagulants / adverse effects*
  • Clinical Decision Rules*
  • Clinical Decision-Making
  • Fibrinolytic Agents / adverse effects*
  • Hemorrhage / chemically induced*
  • Humans
  • Platelet Aggregation Inhibitors / adverse effects*
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors