Clot Chronicles: Antithrombotic Therapy in Patients with Coexisting Cardiovascular and Gastrointestinal Disease

Welcome to Clot Chronicles, a series highlighting contributions from our Executive and Medical Advisory Boards to keep you up to date on the latest thrombosis research. Along with concise, clinically focused summaries, you’ll also have access to videos featuring our board members and their work.

In this episode of Clot Chronicles, we’re proud to share work featuring contributions from Drs. Behnood Bikdeli (NATF Medical Advisory Board) and John Fanikos (NATF Treasurer and Director of Strategic Initiatives). 

In the video below, Dr. Fanikos provides an overview of—and key takeaways from—a recent review article published in Nature Reviews Cardiology on optimizing antithrombotic therapy in patients with both cardiovascular (CV) and gastrointestinal (GI) disease. 


The management of antithrombotic therapy in patients with concomitant CV and GI disease can be challenging, given the need to balance efficacy and safety. This review paper discusses factors to consider when prescribing antithrombotic therapy for patients with CV and GI disease, summarizes evidence gaps, and emphasizes the need for personalized treatment plans based on recommendations from medical societies.

Key Takeaways

  1. Balancing antithrombotic therapy safety and efficacy in gastrointestinal disorder patients is challenging due to drug absorption interference and increased bleeding risk.
  2. Clinical conditions/states like malabsorption syndromes, bariatric surgery, and enteral tube feeding affect oral antithrombotic drug absorption and availability.
  3. Managing antithrombotic therapy in patients with high gastrointestinal bleeding risk requires identifying risk factors, using gastroprotective agents, and carefully adjusting therapy after acute bleeding episodes.
  4. In the setting of active GI bleeding, therapy can be stopped for a few days.

Implications for Clinical Practice

Implementing strategies to identify patients at high risk for GI bleeding and tailoring antithrombotic therapy regimens to prevent bleeding events is critical to optimizing outcomes in patients with coexisting CV and GI disease.


We encourage you to watch this short video to gain a deeper understanding of the article’s significance and potential implications for patient care.

See what John Fanikos has to say about the article below!

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