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Major bleeding rates in atrial fibrillation patients on single, dual, or triple antithrombotic therapy: Results from a nationwide Danish cohort study

Circulation Dec 19, 2018

van Rein N, et al. - Researchers conducted a nationwide cohort study of Danish atrial fibrillation patients aged 50 years or older to assess data on bleeding rates in this high-risk group that receive anticoagulant therapy and platelet aggregation inhibitors in combination. Treatments included no anticoagulant treatment, and treatment with vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs), platelet inhibitors, and combinations of antithrombotic drugs. They studied 272,315 patients with atrial fibrillation indicating high rates of major bleeding among patients with atrial fibrillation on triple therapy compared with patients on dual therapy or monotherapy. The high bleeding rates observed in patients on triple therapy over the age of 90 years or with a CHA2DS2-VASc score over 6 or with a history of a major bleeding, led researchers to recommend practicing caution administering such therapy in these patients.
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