Don’t Delay Restarting Anticoagulation for Atrial Fib After a GI Bleed

Up to half of patients with atrial fib permanently discontinue anticoagulation after a GI bleed.

But these patients are more likely to die from a stroke than from another GI bleed. And evidence suggests that restarting anticoagulation is usually worth the extra bleeding risk.

Advise restarting an anticoagulant in most patients with atrial fib...especially those at high stroke risk. These are patients with a prior stroke or TIA, age 75 or older, diabetes plus hypertension, etc.