Restarting anticoagulation after bleeding

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Approach (per CSIM 2017)

  • Determine cause of bleeding and risk for re-bleeding
  • Resume anticoagulation in most patients
  • Re-start ≤1 week if self-limiting bleed
  • Delay re-start for 2-4 weeks if higher bleed risk
  • Address modifiable bleeding risk factors
    • Ensure good BP control (target: 130/80 mmHg)
    • Stop non-essential antiplatelet drugs (ASA or NSAIDs)