Blood Thinners Risks

References (selected high-quality sources)

This is a curated list of major randomized trials, reversal-agent studies, and guideline statements from leading journals and professional societies. It is not exhaustive.

Tip: If you want a clinician to take a specific issue seriously (e.g., DOAC reversal, intracranial bleed), bringing the relevant guideline citation can help.

Major AF trials (DOACs vs warfarin)

  • Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus Warfarin in Patients with Atrial Fibrillation (RE-LY). New England Journal of Medicine. 2009.
  • Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation (ROCKET AF). New England Journal of Medicine. 2011.
  • Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus Warfarin in Patients with Atrial Fibrillation (ARISTOTLE). New England Journal of Medicine. 2011.
  • Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus Warfarin in Patients with Atrial Fibrillation (ENGAGE AF–TIMI 48). New England Journal of Medicine. 2013.

Major VTE trials (treatment / secondary prevention)

  • Bauersachs R, Berkowitz SD, Brenner B, et al. Oral Rivaroxaban for Symptomatic Venous Thromboembolism (EINSTEIN-DVT). New England Journal of Medicine. 2010.
  • The EINSTEIN–PE Investigators. Oral Rivaroxaban for the Treatment of Symptomatic Pulmonary Embolism. New England Journal of Medicine. 2012.
  • Agnelli G, Buller HR, Cohen A, et al. Oral Apixaban for the Treatment of Acute Venous Thromboembolism (AMPLIFY). New England Journal of Medicine. 2013.
  • Buller HR, Decousus H, Grosso MA, et al. Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism (Hokusai-VTE). New England Journal of Medicine. 2013.
  • Schulman S, Kearon C, Kakkar AK, et al. Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism (RE-COVER). New England Journal of Medicine. 2009.

Reversal agents & major bleeding

  • Pollack CV Jr, Reilly PA, Eikelboom J, et al. Idarucizumab for Dabigatran Reversal. New England Journal of Medicine. 2015. doi:10.1056/NEJMoa1502000.
  • Pollack CV Jr, Reilly PA, van Ryn J, et al. Idarucizumab for Dabigatran Reversal — Full Cohort Analysis. New England Journal of Medicine. 2017.
  • Connolly SJ, Crowther M, Eikelboom JW, et al. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors (ANNEXA-4). New England Journal of Medicine. 2019. doi:10.1056/NEJMoa1814051.

Guidelines & consensus statements

  • Joglar JA, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation. Circulation. 2024.
  • Greenberg SM, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage. Stroke. 2022.
  • European Society of Cardiology (ESC). Guidelines for the diagnosis and management of atrial fibrillation. European Heart Journal. 2020.
  • American Society of Hematology (ASH). Guidelines for management of venous thromboembolism. Blood Advances / ASH guideline publications (various years).
  • CHEST Guideline and Expert Panel Reports on antithrombotic therapy for VTE disease (CHEST, various editions).

Further reading (high quality)

  • Clinical reviews in JAMA, The Lancet, Circulation, and Stroke on anticoagulation safety, DOAC use, and bleeding management.

If you want, I can expand this list into a properly formatted bibliography (APA/Vancouver) with PubMed links on a follow-up pass.