{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:27:45Z","timestamp":1791239265741,"version":"4.1.0"},"reference-count":228,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Whilst there is a clear clinical benefit of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and venous thromboembolism (VTE) in reducing the risks of thromboembolism, major bleeding events (especially intracranial bleeds) may still occur and be devastating. The decision to initiate and continue anticoagulation is often based on a careful assessment of both the thromboembolism and bleeding risk. The more common and validated bleeding risk factors have been used to formulate bleeding risk stratification scores, but thromboembolism and bleeding risk factors often overlap. Also, many factors that increase bleeding risk are transient and modifiable, such as variable international normalized ratio values, surgical procedures, vascular procedures, or drug\u2013drug and food\u2013drug interactions. Bleeding risk is also not a static \u2018one off\u2019 assessment based on baseline factors but is dynamic, being influenced by ageing, incident comorbidities, and drug therapies. In this Consensus Document, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in patients with AF and VTE, with the view to summarizing \u2018best practice\u2019 when approaching antithrombotic therapy in these patients. We address the epidemiology and size of the problem of bleeding risk in AF and VTE, review established bleeding risk factors, and summarize definitions of bleeding. Patient values and preferences, balancing the risk of bleeding against thromboembolism are reviewed, and the prognostic implications of bleeding are discussed. We propose consensus statements that may help to define evidence gaps and assist in everyday clinical practice.<\/jats:p>","DOI":"10.1093\/europace\/euac020","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T15:12:43Z","timestamp":1644333163000},"page":"1844-1871","source":"Crossref","is-referenced-by-count":60,"title":["Assessment and mitigation of bleeding risk in atrial fibrillation and venous thromboembolism: A Position Paper from the ESC Working Group on Thrombosis, in collaboration with the European Heart Rhythm Association, the Association for Acute CardioVascular Care and the Asia-Pacific Heart Rhythm Society"],"prefix":"10.1093","volume":"24","author":[{"given":"Diana A","family":"Gorog","sequence":"first","affiliation":[{"name":"School of Life and Medical Sciences, Postgraduate Medical School, University of Hertfordshire, College Lane , Hatfield ,","place":["UK"]},{"name":"Faculty of Medicine, National Heart & Lung Institute, Imperial College , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9994-8915","authenticated-orcid":false,"given":"Ying X","family":"Gue","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital , Taipei ,","place":["Taiwan"]},{"name":"Institute of Clinical Medicine, Cardiovascular Research Center, National Yang Ming Chiao Tung University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-1658","authenticated-orcid":false,"given":"Laurent","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Tours , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Ferreiro","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Bellvitge, Ciber Cardiovascular (CIBERCV) , L\u2019Hospitalet de Llobregat, Barcelona ,","place":["Spain"]},{"name":"BIOHEART-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge\u2014IDIBELL , L\u2019Hospitalet de Llobregat, Barcelona 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Department of Clinical Medicine, Aalborg University , Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Marin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca (IMIB-Arrixaca), CIBERCV, Universidad de Murcia , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-3921","authenticated-orcid":false,"given":"Jonas","family":"Oldgren","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University , Uppsala ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6285-6902","authenticated-orcid":false,"given":"Tatjana","family":"Potpara","sequence":"additional","affiliation":[{"name":"School of Medicine, Belgrade University , Belgrade ,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Roldan","sequence":"additional","affiliation":[{"name":"Servicio de Hematolog\u00eda, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca , Murcia, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rubboli","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiovascular Diseases\u2014AUSL Romagna, SMaria delle Croci Hospital , Ravenna ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-2696","authenticated-orcid":false,"given":"Dirk","family":"Sibbing","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance , Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Hong Kong , Hong Kong ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Vilahur","sequence":"additional","affiliation":[{"name":"Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau , Barcelona ,","place":["Spain"]},{"name":"CIBERCV Instituto de Salud Carlos III , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital , Liverpool ,","place":["UK"]},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University , Aalborg 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