{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:53:27Z","timestamp":1790398407612,"version":"4.1.0"},"reference-count":75,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This position paper offers expert guidance on managing anticoagulant therapy in athletes and sportspeople, addressing the unique challenges posed by the dual need for effective thromboprophylaxis and maintenance of athletic performance. Recognizing that conditions such as atrial fibrillation and venous thromboembolism occur with higher prevalence in athletes due to factors like intense physical training, dehydration, trauma, and long-haul travel, the paper reviews current literature and expert opinions from the Italian Federation of Centers for Diagnosis and Surveillance of the Antithrombotic Therapies. The manuscript highlights that although direct oral anticoagulants (DOACs) are generally preferred for their favorable efficacy and safety profile compared with traditional vitamin K antagonists (VKAs), their use in sports demands careful risk stratification. To balance effective anticoagulation with the risk of bleeding, individualized treatment strategies\u2014including intermittent dosing regimens with DOACs\u2014are suggested. These strategies aim to minimize bleeding risk during periods of high physical demand while preserving therapeutic effectiveness. In athletes requiring VKA therapy, sport participation\u2014especially contact or high-impact activities\u2014should be strongly discouraged due to the inability to manage bleeding and thrombotic risks safely. Moreover, the paper emphasizes the importance of periodic re-assessment of thromboembolic and hemorrhagic risks, multidisciplinary collaboration among cardiologists, hematologists, and sports medicine specialists, and shared decision-making with the athlete. By offering practical suggestions on treatment modifications, return-to-play protocols, and patient education, this position paper serves as a critical resource for clinicians striving to optimize anticoagulant therapy in athletic populations without compromising competitive performance.<\/jats:p>","DOI":"10.1055\/a-2632-3197","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T19:35:17Z","timestamp":1749670517000},"page":"1085-1098","source":"Crossref","is-referenced-by-count":4,"title":["Management of Anticoagulant Therapy in Athletes and Sportspeople: Italian Federation of Centers for Diagnosis and Surveillance of the Antithrombotic Therapies (FCSA) Position Paper"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-3741","authenticated-orcid":false,"given":"Elena","family":"Campello","sequence":"additional","affiliation":[{"name":"Internal Medicine 1, Thrombotic and Hemorrhagic Disease Unit, Department of Medicine, Padova University Hospital, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cappugi","sequence":"additional","affiliation":[{"name":"Medicina Interna, Nuovo Ospedale San Giovanni di Dio, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Catalani","sequence":"additional","affiliation":[{"name":"Internal Medicine 1, Thrombotic and Hemorrhagic Disease Unit, Department of Medicine, Padova University Hospital, Padova, Italy"},{"name":"Department of Internal Medicine, Regional Hospital of Bellinzona e Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Poli","sequence":"additional","affiliation":[{"name":"Thrombosis Center, \u201cCareggi\u201d Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bucciarelli","sequence":"additional","affiliation":[{"name":"Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1136\/jim-2020-001658","article-title":"Anticoagulation and antiplatelet therapy in contact sports: is it career limiting?","volume":"69","author":"A Kichloo","year":"2021","journal-title":"J Investig Med"},{"key":"ref2","first-page":"S63","article-title":"Atrial fibrillation in elite athletes","volume":"9","author":"F Furlanello","year":"1998","journal-title":"J Cardiovasc 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