RT Journal Article
SR Electronic
T1 Thrombotic ‘rebound’ after withdrawal of oral anticoagulants
JF Drug and Therapeutics Bulletin
JO Drug Ther Bull
FD BMJ Publishing Group Ltd
SP 92
OP 92
DO 10.1136/dtb.4.23.92
VO 4
IS 23
YR 1966
UL http://dtb.bmj.com/content/4/23/92.abstract
AB The possibility that a hypercoagulable state (‘thrombotic rebound’) may follow anticoagulant therapy1 continues to arouse interest. In a group of patients with various disorders thrombo-embolic complications occurred particularly in the first month after stopping the anticoagulant for three days or more because of bleeding, but were distributed randomly over many months when therapy was withdrawn permanently for other reasons.2 In another study, in patients with non-haemorrhagi strokes due to cerebrovascular disease, the incidence of further non-fatal attacks was significantly increased after gradual withdrawal of anticoagulants over one month,3 although comparison with a control group showed that anticoagulants were quite ineffective in preventing such recurrences.4 5 On the other hand no withdrawal effect was found in two studies of patients with ischaemic heart disease,6 7 or in the incidence of venous thrombosis in a series of injured persons.8