2) We spend alot of time discussing in these programs the management of the most feared 🩸 complication of #DOAC therapy–#ICH. We respect it! But we also must recognize that the most COMMON 🩸issue in this space is from the #gastrointestinal tract.
— cardio-met (@cardiomet_CE) May 28, 2024
4a) Let's start with a quiz!
— cardio-met (@cardiomet_CE) May 28, 2024
Guidelines suggest that #anticoagulant #reversal or #repletion/#hemostatic therapies be reserved for patients with life-threatening #GIbleeding #GIB who have taken a #DOAC within the previous ___ hours:
5) So let's kick this off!
— cardio-met (@cardiomet_CE) May 28, 2024
Oral #anticoagulants #OAC are used widely to prevent and treat #cardiovascular disease which is the leading cause of death ☠️and disability 🦽🛏️ worldwide.
See https://t.co/pjGFo8YBfX pic.twitter.com/AYnY3XC4E2
7) Bleeding is an important complication of #anticoagulant therapy (even in 2024) and is the most common adverse drug event leading to emergency department #ED visits, hospital 🏥admissions, and death 🪦.
— cardio-met (@cardiomet_CE) May 28, 2024
See 🔓 https://t.co/TOvEFEEb73 pic.twitter.com/IsqvfVpLQz
9) As the most common site of #extracranial bleeding, anticoagulant-related #GIB is associated with substantial short-term mortality.
— cardio-met (@cardiomet_CE) May 28, 2024
See 🔓 https://t.co/4ao3M5dBjV pic.twitter.com/W06pwXh5jL
11) Identifying and addressing modifiable risk factors is important for reducing the incidence of #GIB events. See
— cardio-met (@cardiomet_CE) May 28, 2024
🔓 https://t.co/8vDdL1aOOC
🔓 https://t.co/E8iKWXgJax
🔓 https://t.co/bU4E9roSrF pic.twitter.com/JsUoU4LLee
12b) It's also important to address resumption of #anticoagulation after bleed cessation & to implement secondary #prevention strategies. See https://t.co/IqRjCqJ8CX pic.twitter.com/aLeVGXpvj5
— cardio-met (@cardiomet_CE) May 28, 2024
13b) BTW the article referenced in 13a ⤴️ was covered in a @cardiomet_CE #JournalClub and the CE/#CME from that program is still active at https://t.co/uHASaIa7Sj. Go get some more #MedEd! pic.twitter.com/Ktu178HaKv
— cardio-met (@cardiomet_CE) May 28, 2024
15a) Guidelines suggest that #anticoagulant #reversal or hemostatic therapies be reserved for pts w/life-threatening #GIB who have taken a #DOAC within the previous 24h. These are conditional recommendations based on very low certainty of evidence.
— cardio-met (@cardiomet_CE) May 28, 2024
See https://t.co/oUKBJHbcZI pic.twitter.com/r1zCxIEhL9
15c) When needed, though, for severe/life-threatening bleeding when rapid hemostasis is required prompt #reversal or #hemostatic treatment may reduce bleed severity and complications (e.g. hypotension, hypoxic tissue injury, anemia, transfusion).
— cardio-met (@cardiomet_CE) May 28, 2024
17) In this analysis, 7% of pts experienced thrombotic events within 30d follow-up. #Anticoagulation (of any type/dose) was reinitiated in 59% including #OAC in 46%. Similar to prior studies, the high mortality rate of 12% ➡️#GIB are not trivial complications of anticoagulation. pic.twitter.com/6uB627oB4O
— cardio-met (@cardiomet_CE) May 28, 2024
19) Secondary #prevention strategies help to mitigate bleeding risk for patients requiring long-term #anticoagulant treatment. pic.twitter.com/Q8JKG3SH1q
— cardio-met (@cardiomet_CE) May 28, 2024
21) And you have just earned 0.5 hr 🆓 CE/#CME! Claim your certificate NOW at https://t.co/Ifa7xcnB3o. Thanks for following this 🧵, for following @cardiomet_ce for MORE #MedEd, and thanks to our expert faculty @DebSiegal !
— cardio-met (@cardiomet_CE) May 28, 2024
22) BTW, we mentioned the great interest in #DOAC-associated #ICH. We want to make note that the primary analysis of #ANNEXa_I, which has been addressed often on @cardiomet_ce, is now published @nejm at https://t.co/T8UrNqqfgY.
— cardio-met (@cardiomet_CE) May 28, 2024