PMID- 15383476
OWN - NLM
STAT- MEDLINE
DCOM- 20041026
LR  - 20220318
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 126
IP  - 3 Suppl
DP  - 2004 Sep
TI  - Hemorrhagic complications of anticoagulant treatment: the Seventh ACCP Conference 
      on Antithrombotic and Thrombolytic Therapy.
PG  - 287S-310S
AB  - This chapter about hemorrhagic complications of anticoagulant treatment is part 
      of the seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: 
      Evidence Based Guidelines. Bleeding is the major complication of anticoagulant 
      therapy. The criteria for defining the severity of bleeding varies considerably 
      between studies, accounting in part for the variation in the rates of bleeding 
      reported. The major determinants of vitamin K antagonist-induced bleeding are the 
      intensity of the anticoagulant effect, underlying patient characteristics, and 
      the length of therapy. There is good evidence that vitamin K antagonist therapy, 
      targeted international normalized ratio (INR) of 2.5 (range, 2.0 to 3.0), is 
      associated with a lower risk of bleeding than therapy targeted at an INR > 3.0. 
      The risk of bleeding associated with IV unfractionated heparin (UFH) in patients 
      with acute venous thromboembolism (VTE) is < 3% in recent trials. This bleeding 
      risk may increase with increasing heparin dosages and age (> 70 years). Low 
      molecular weight heparin (LMWH) is associated with less major bleeding compared 
      with UFH in acute VTE. UFH and LMWH are not associated with an increase in major 
      bleeding in ischemic coronary syndromes, but are associated with an increase in 
      major bleeding in ischemic stroke. Information on bleeding associated with the 
      newer generation of antithrombotic agents has begun to emerge. In terms of 
      treatment decision making for anticoagulant therapy, bleeding risk cannot be 
      considered alone, ie, the potential decrease in thromboembolism must be balanced 
      against the potential increased bleeding risk.
FAU - Levine, Mark N
AU  - Levine MN
AD  - Henderson Research Centre, 711 Concession St, Hamilton, Ontario L8V 1C3.
FAU - Raskob, Gary
AU  - Raskob G
FAU - Beyth, Rebecca J
AU  - Beyth RJ
FAU - Kearon, Clive
AU  - Kearon C
FAU - Schulman, Sam
AU  - Schulman S
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 12001-79-5 (Vitamin K)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/administration & dosage/*adverse effects/pharmacokinetics
MH  - Dose-Response Relationship, Drug
MH  - Evidence-Based Medicine
MH  - Hemorrhage/blood/*chemically induced/prevention & control
MH  - Heparin/administration & dosage/adverse effects/pharmacokinetics
MH  - Heparin, Low-Molecular-Weight/administration & dosage/adverse 
      effects/pharmacokinetics
MH  - Humans
MH  - International Normalized Ratio
MH  - Randomized Controlled Trials as Topic
MH  - Risk Assessment
MH  - Thromboembolism/blood/*drug therapy
MH  - Vitamin K/antagonists & inhibitors
RF  - 271
EDAT- 2004/09/24 05:00
MHDA- 2004/10/27 09:00
CRDT- 2004/09/24 05:00
PHST- 2004/09/24 05:00 [pubmed]
PHST- 2004/10/27 09:00 [medline]
PHST- 2004/09/24 05:00 [entrez]
AID - S0012-3692(15)31495-1 [pii]
AID - 10.1378/chest.126.3_suppl.287S [doi]
PST - ppublish
SO  - Chest. 2004 Sep;126(3 Suppl):287S-310S. doi: 10.1378/chest.126.3_suppl.287S.