Challenges in managing patients on anticoagulation: Thrombocytopenia, resumption after bleeding and recurrent...

Area of Science:

• Cardiology
• Hematology
• Internal Medicine

Background:

• Anticoagulation prescribing is increasing globally due to aging populations and improved cancer survival.
• Cardiovascular comorbidities like arrhythmias and prosthetic heart valves necessitate anticoagulation.
• Managing complex anticoagulation scenarios presents significant clinical challenges.

Purpose of the Study:

• To review common challenges in anticoagulation management.
• To provide practical management suggestions for clinicians.
• To discuss evidence and recommendations for complex anticoagulation cases.

Main Methods:

• Review of current literature and published recommendations.
• Discussion of clinical dilemmas in anticoagulation.
• Synthesis of evidence for practical management strategies.

Main Results:

• Identified three key challenges: thrombosis with thrombocytopenia, anticoagulation resumption post-hemorrhage, and recurrent thrombosis on therapy.
• Considered available evidence and clinical guidelines.
• Proposed practical management approaches for each dilemma.

Conclusions:

• Clinicians face significant challenges in managing anticoagulation therapy.
• Practical guidance is needed for complex cases involving thrombosis, hemorrhage, and recurrence.
• Evidence-based recommendations can aid in optimizing patient care and safety.