Bleeding events during anticoagulation in patients with hereditary hemorrhagic telangiectasia.

Abstract Despite being a hemorrhagic condition, patients with hereditary hemorrhagic telangiectasia (HHT) are at increased thromboembolic risk. We designed an observational retrospective cohort study of HHT patients who required anticoagulation therapy, described their indications and adverse events. From January 2006 until August 2019 28 out of 347 adult HHT patients received anticoagulant drugs for a median of 0.5 years (IQR 0.2–4.1). Median age was 64 years (IQR 51–70), all of the patients had epistaxis and at least one arteriovenous malformation. Fourteen (50%) patients received anticoagulants due to venous thromboembolic disease and 6 (21.4%) for atrial fibrillation. Nine patients (32.1%) received low-molecular-weight heparin and 19 (67.9%) vitamin-K antagonists. Seven (25%) withdrew treatment due to increased bleeding frequency from usual sites and 5 (17.9%) had a major bleeding event. Ten (35.7%) patients completed short length anticoagulation without significant adverse events.