ArticleJournal of internal medicine2025
Excess risk of bleeding in patients with venous thromboembolism on direct oral anticoagulants during initial and extended treatment versus population controls.
Article in Journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robustness of placebo-controlled trials of extended-duration direct oral anticoagulant therapy for secondary venous thromboembolism prevention.Internal and emergency medicine · 2026Pooled it
- Comparison of monthly bleeding rates after direct oral anticoagulant initiation for venous thromboembolism and atrial fibrillation.Research and practice in thrombosis and haemostasis · 2026Article
- Article
- Venous Thromboembolism in Inherited Platelet Disorders: A Clinical Challenge.Diagnostics (Basel, Switzerland) · 2025Review
- Association of loneliness and social isolation with excess risk of cardiovascular events in people with obesity: a prospective cohort study.Journal of global health · 2025Article
- Excess risk of bleeding in patients with venous thromboembolism on direct oral anticoagulants during initial and extended treatment versus population controls.Journal of internal medicine · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe risk of major bleeding from anticoagulant treatment is influenced by both the treatment and the patient's baseline risk, which is often disregarded.
objectivesTo determine the excess bleeding risk in venous thromboembolism (VTE) cases during initial (0 to 6 months) and extended (6 months to 5 years) treatment compared to matched population controls without VTE or anticoagulant treatment, overall, and stratified by sex and age.
methodsCancer-free patients with VTE treated with direct oral anticoagulants from 2014 to 2020, along with propensity score-matched controls, were identified from nationwide Swedish registers. Excess risk of major bleeding was assessed using the incidence rate difference (IRD) calculated by subtracting the control bleeding rate from the case bleeding rate.
resultsThe matched cohort comprised 36,115 VTE cases and 36,115 controls. During initial treatment, 388 VTE cases (1.07%) and 103 controls (0.29%) experienced bleeding, IRD: 2.19 (95% confidence interval 1.89-2.49) per 100 person-years. Following rematching at 6 months, 139 cases (0.70%) and 214 controls (1.08%) experienced bleeding, IRD: 0.70 (0.52-0.89). During initial treatment, females had a higher excess bleeding risk than males, with male IRD: 1.73 (1.34-2.12) and female IRD: 2.69 (2.23-3.15). Excess bleeding risk was highest in the oldest patient population. In extended treatment, excess bleeding was not dependent on sex-male IRD: 0.60 (0.35-0.85), female IRD: 0.81 (0.54-1.08)-and did not increase with age.
conclusionThe excess bleeding risk from anticoagulant treatment was high during initial treatment, particularly among females and the elderly, but lower and not influenced by sex or age during extended treatment.
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