Evidence & medical references

How to use these sources

All links below go to PubMed (abstract page). Where a PubMed ID (PMID) is known, the link goes directly to the record; otherwise it uses a PubMed search link.

Reminder: educational only — not medical advice. Follow your clinician’s instructions and local emergency guidance.

Atrial fibrillation — stroke prevention (anticoagulants)

• Connolly SJ, et al. Dabigatran versus warfarin in patients with atrial fibrillation (RE-LY). NEJM. 2009.
• Granger CB, et al. Apixaban versus warfarin in patients with atrial fibrillation (ARISTOTLE). NEJM. 2011.
• Patel MR, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation (ROCKET AF). NEJM. 2011.
• Giugliano RP, et al. Edoxaban versus warfarin in patients with atrial fibrillation (ENGAGE AF–TIMI 48). NEJM. 2013.
• Meta-analyses of DOACs vs warfarin in AF (randomized trials; efficacy/bleeding outcomes) — PubMed search.

“Risk of not taking when you should” — interruption, discontinuation, nonadherence

• Anticoagulant discontinuation in AF and stroke/systemic embolism risk (observational cohorts) — PubMed search.
• DOAC nonadherence and thromboembolic outcomes in AF (real‑world studies) — PubMed search.
• Douketis JD, et al. Perioperative bridging anticoagulation in patients with AF (BRIDGE). NEJM. 2015.

Venous thromboembolism (DVT / PE) — treatment & recurrence prevention

• EINSTEIN‑DVT (rivaroxaban for acute DVT). NEJM. 2010 — PubMed search.
• Agnelli G, et al. Oral apixaban for the treatment of acute venous thromboembolism (AMPLIFY). NEJM. 2013.
• Hokusai‑VTE (edoxaban for VTE). NEJM. 2013 — PubMed search.
• RE‑COVER (dabigatran for acute VTE). NEJM. 2009 — PubMed search.
• CHEST guideline foundations for VTE antithrombotic therapy (evidence syntheses) — PubMed search.

Cancer‑associated thrombosis — clot recurrence vs bleeding trade‑offs

• Hokusai VTE Cancer (edoxaban vs dalteparin). NEJM. 2018 — PubMed search.
• CARAVAGGIO (apixaban vs dalteparin). NEJM. 2020 — PubMed search.

Coronary artery disease / stents — antiplatelets & bleeding risk (DAPT)

• Mauri L, et al. Duration of dual antiplatelet therapy after drug‑eluting stents (DAPT trial). NEJM. 2014 — PubMed search.
• ACC/AHA focused update on DAPT duration (evidence review foundation). Circulation. 2016 — PubMed search.
• Valgimigli M, et al. Dual antiplatelet therapy after PCI (review). Eur Heart J. 2018 — PubMed search.

Mechanical heart valves — DOAC harm signal (warfarin required)

• Eikelboom JW, et al. Dabigatran versus warfarin in patients with mechanical heart valves (RE-ALIGN). NEJM. 2013.
• AHA/ACC valvular guideline update (mechanical valves; anticoagulation) — PubMed search.

Bleeding risks — gastrointestinal and intracranial

• Warfarin major hemorrhage risk in older adults (cohort data). Circulation. 2007 — PubMed search.
• DOACs vs warfarin: intracranial hemorrhage risk (meta‑analyses) — PubMed search.
• DOACs vs warfarin: GI bleeding risk (meta‑analyses) — PubMed search.

Trauma / head injury on blood thinners

• Pre‑injury anticoagulation and outcomes after trauma (systematic reviews) — PubMed search.
• Delayed intracranial hemorrhage after head injury on anticoagulants (systematic reviews) — PubMed search.

Emergency reversal & “what to do in a major bleed”

• Pollack CV Jr, et al. Idarucizumab for dabigatran reversal. NEJM. 2015.
• Connolly SJ, et al. Andexanet alfa for factor Xa inhibitor reversal. NEJM. 2016.
• ANNEXA‑I: andexanet for factor Xa inhibitor–associated intracerebral hemorrhage. NEJM. 2024 — PubMed search.

Age & net clinical benefit

• Net clinical benefit of warfarin in AF (risk–benefit modeling). Ann Intern Med. 2009 — PubMed search.
• Reviews on anticoagulation in older adults (stroke reduction vs bleeding). — PubMed search.