Long-term risk for major bleeding during extended oral anticoagulant therapy for first unprovoked venous thromboembolism: A Systematic Review and Meta-analysis

Annals of Internal Medicine
Review (14 RCTs;13 cohort studies; n=17,202) found long-term risks & consequences of anticoagulant-related major bleeding are considerable in this population (incidence/100 person-years =1.74 events with VKAs & 1.12 events with DOACs;5-year cumulative incidence with VKAs was 6.3%.

Utilization and long-term persistence of direct oral anticoagulants among patients with nonvalvular atrial fibrillation and liver disease

British Journal of Clinical Pharmacology
UK study (n=3167; 71% on DOACs; 29% vitamin K antagonists [VKA]) found initiators of DOACs were more likely to have prior ischemic stroke (OR 1.44), less likely to have used antiplatelets (OR 0.66) and more likely to persist with treatment at 5 years vs VKAs (31% vs 9%).

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