Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry

Sebastián Seni-Molina; Santiago Posso Marín; Juan Esteban Masmela; María Camila Naranjo-Ramirez; Arturo D. Mora; Juliana María Gutierrez-Posso; Julio Diez-Sepúlveda; Juan David Victoria-Salcedo; Ana Cristina Montenegro Arenas; Camilo Andrés Rueda Ortiz; Edgar David Gómez Lahitton; Hoover Leon-Giraldo; Juan Esteban Gómez-Mesa

doi:10.1016/j.tru.2025.100215

Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry

Sebastián Seni-Molina, Santiago Posso Marín, Juan Esteban Masmela, María Camila Naranjo-Ramirez, Arturo D. Mora, Juliana María Gutierrez-Posso, Julio Diez-Sepúlveda, Juan David Victoria-Salcedo, Ana Cristina Montenegro Arenas, Camilo Andrés Rueda Ortiz, Edgar David Gómez Lahitton, Hoover Leon-Giraldo, Juan Esteban Gómez-Mesa

Research output: Contribution to journal › Article › peer-review

Abstract

Background Anticoagulation reversal is critical in emergency settings for patients experiencing anticoagulant-related bleeding or requiring invasive or surgical procedures. Despite its importance, evidence in Colombia is limited. Methods RECCANT-AR (Registro Colombiano de Clínicas de Anticoagulación y el Uso de Agentes Reversores) is a multicenter, observational, ambispective study analyzing anticoagulated patients requiring reversal therapy due to bleeding or procedural needs. Data from the first 144 patients across four institutions were analyzed to describe their sociodemographic and clinical profiles. Results The cohort had a mean age of 66.9 years (SD ± 15.3) and a nearly equal sex distribution. Ethnicity was predominantly Mestizo (67.5%), followed by White (17.5%) and Afrodescendant (13.3%). The most common comorbidities were hypertension (61.8%), previous venous thromboembolism episodes (31.3%), dyslipidemia (30.6%), and diabetes mellitus (21.5%). Warfarin was the predominant anticoagulant (84%), followed by apixaban (4.9%) and dabigatran (4.2%). Bleeding was the primary indication for reversal (92.4%), while surgical needs accounted for 7.6% of cases. The most used reversal agents were vitamin K (75%) and prothrombin complex concentrates (27.1%). Hospitalization was required in 82% of cases, with 55.1% admitted to intensive care. The mortality rate was 7.6%. Conclusion Our study is the first multicenter characterization of anticoagulated patients requiring reversal therapy in Colombia. Cardiovascular comorbidities were highly prevalent. Bleeding was the leading indication for reversal, and warfarin the most used anticoagulant, likely reflecting its higher bleeding risk. Limited availability of direct oral anticoagulant-specific reversal agents remains a challenge. High hospitalization and mortality rates underscore the high-risk nature of this population, emphasizing the need for improved access to reversal agents and optimized anticoagulation practices. Further research is warranted.

Original language	English
Journal	Thrombosis Update
DOIs	https://doi.org/10.1016/j.tru.2025.100215
State	Published - 1 Jul 2025

Centers and Institutes Mederi

Adult Haematology Institute

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.tru.2025.100215

https://www.sciencedirect.com/science/article/pii/S2666572725000185

Colombian Registry of Anticoagulation Clinics and the Use of Reversal Agents
Gomez-Mesa, J. E. (PI), Rueda Ortíz, C. A. (CoI) & Torres Castillo, J. (CoI)
22/04/24 → …
Project: Clinical Data Registry

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Seni-Molina, S., Marín, S. P., Masmela, J. E., Naranjo-Ramirez, M. C., Mora, A. D., Gutierrez-Posso, J. M., Diez-Sepúlveda, J., Victoria-Salcedo, J. D., Montenegro Arenas, A. C., Rueda Ortiz, C. A., Gómez Lahitton, E. D., Leon-Giraldo, H., & Gómez-Mesa, J. E. (2025). Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry. Thrombosis Update. https://doi.org/10.1016/j.tru.2025.100215

@article{4637491dbc4e4974ba79cba20f82bcf7,

title = "Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry",

abstract = "Background Anticoagulation reversal is critical in emergency settings for patients experiencing anticoagulant-related bleeding or requiring invasive or surgical procedures. Despite its importance, evidence in Colombia is limited. Methods RECCANT-AR (Registro Colombiano de Cl{\'i}nicas de Anticoagulaci{\'o}n y el Uso de Agentes Reversores) is a multicenter, observational, ambispective study analyzing anticoagulated patients requiring reversal therapy due to bleeding or procedural needs. Data from the first 144 patients across four institutions were analyzed to describe their sociodemographic and clinical profiles. Results The cohort had a mean age of 66.9 years (SD ± 15.3) and a nearly equal sex distribution. Ethnicity was predominantly Mestizo (67.5%), followed by White (17.5%) and Afrodescendant (13.3%). The most common comorbidities were hypertension (61.8%), previous venous thromboembolism episodes (31.3%), dyslipidemia (30.6%), and diabetes mellitus (21.5%). Warfarin was the predominant anticoagulant (84%), followed by apixaban (4.9%) and dabigatran (4.2%). Bleeding was the primary indication for reversal (92.4%), while surgical needs accounted for 7.6% of cases. The most used reversal agents were vitamin K (75%) and prothrombin complex concentrates (27.1%). Hospitalization was required in 82% of cases, with 55.1% admitted to intensive care. The mortality rate was 7.6%. Conclusion Our study is the first multicenter characterization of anticoagulated patients requiring reversal therapy in Colombia. Cardiovascular comorbidities were highly prevalent. Bleeding was the leading indication for reversal, and warfarin the most used anticoagulant, likely reflecting its higher bleeding risk. Limited availability of direct oral anticoagulant-specific reversal agents remains a challenge. High hospitalization and mortality rates underscore the high-risk nature of this population, emphasizing the need for improved access to reversal agents and optimized anticoagulation practices. Further research is warranted.",

keywords = "Anticoagulation, anticoagulation reversal, bleeding, Colombia, surgical procedures",

author = "Sebasti{\'a}n Seni-Molina and Mar{\'i}n, {Santiago Posso} and Masmela, {Juan Esteban} and Naranjo-Ramirez, {Mar{\'i}a Camila} and Mora, {Arturo D.} and Gutierrez-Posso, {Juliana Mar{\'i}a} and Julio Diez-Sep{\'u}lveda and Victoria-Salcedo, {Juan David} and {Montenegro Arenas}, {Ana Cristina} and {Rueda Ortiz}, {Camilo Andr{\'e}s} and {G{\'o}mez Lahitton}, {Edgar David} and Hoover Leon-Giraldo and G{\'o}mez-Mesa, {Juan Esteban}",

year = "2025",

month = jul,

day = "1",

doi = "10.1016/j.tru.2025.100215",

language = "Ingl{\'e}s",

journal = "Thrombosis Update",

issn = "2666-5727",

}

Seni-Molina, S, Marín, SP, Masmela, JE, Naranjo-Ramirez, MC, Mora, AD, Gutierrez-Posso, JM, Diez-Sepúlveda, J, Victoria-Salcedo, JD, Montenegro Arenas, AC, Rueda Ortiz, CA, Gómez Lahitton, ED, Leon-Giraldo, H & Gómez-Mesa, JE 2025, 'Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry', Thrombosis Update. https://doi.org/10.1016/j.tru.2025.100215

TY - JOUR

T1 - Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry

AU - Seni-Molina, Sebastián

AU - Marín, Santiago Posso

AU - Masmela, Juan Esteban

AU - Naranjo-Ramirez, María Camila

AU - Mora, Arturo D.

AU - Gutierrez-Posso, Juliana María

AU - Diez-Sepúlveda, Julio

AU - Victoria-Salcedo, Juan David

AU - Montenegro Arenas, Ana Cristina

AU - Rueda Ortiz, Camilo Andrés

AU - Gómez Lahitton, Edgar David

AU - Leon-Giraldo, Hoover

AU - Gómez-Mesa, Juan Esteban

PY - 2025/7/1

Y1 - 2025/7/1

N2 - Background Anticoagulation reversal is critical in emergency settings for patients experiencing anticoagulant-related bleeding or requiring invasive or surgical procedures. Despite its importance, evidence in Colombia is limited. Methods RECCANT-AR (Registro Colombiano de Clínicas de Anticoagulación y el Uso de Agentes Reversores) is a multicenter, observational, ambispective study analyzing anticoagulated patients requiring reversal therapy due to bleeding or procedural needs. Data from the first 144 patients across four institutions were analyzed to describe their sociodemographic and clinical profiles. Results The cohort had a mean age of 66.9 years (SD ± 15.3) and a nearly equal sex distribution. Ethnicity was predominantly Mestizo (67.5%), followed by White (17.5%) and Afrodescendant (13.3%). The most common comorbidities were hypertension (61.8%), previous venous thromboembolism episodes (31.3%), dyslipidemia (30.6%), and diabetes mellitus (21.5%). Warfarin was the predominant anticoagulant (84%), followed by apixaban (4.9%) and dabigatran (4.2%). Bleeding was the primary indication for reversal (92.4%), while surgical needs accounted for 7.6% of cases. The most used reversal agents were vitamin K (75%) and prothrombin complex concentrates (27.1%). Hospitalization was required in 82% of cases, with 55.1% admitted to intensive care. The mortality rate was 7.6%. Conclusion Our study is the first multicenter characterization of anticoagulated patients requiring reversal therapy in Colombia. Cardiovascular comorbidities were highly prevalent. Bleeding was the leading indication for reversal, and warfarin the most used anticoagulant, likely reflecting its higher bleeding risk. Limited availability of direct oral anticoagulant-specific reversal agents remains a challenge. High hospitalization and mortality rates underscore the high-risk nature of this population, emphasizing the need for improved access to reversal agents and optimized anticoagulation practices. Further research is warranted.

AB - Background Anticoagulation reversal is critical in emergency settings for patients experiencing anticoagulant-related bleeding or requiring invasive or surgical procedures. Despite its importance, evidence in Colombia is limited. Methods RECCANT-AR (Registro Colombiano de Clínicas de Anticoagulación y el Uso de Agentes Reversores) is a multicenter, observational, ambispective study analyzing anticoagulated patients requiring reversal therapy due to bleeding or procedural needs. Data from the first 144 patients across four institutions were analyzed to describe their sociodemographic and clinical profiles. Results The cohort had a mean age of 66.9 years (SD ± 15.3) and a nearly equal sex distribution. Ethnicity was predominantly Mestizo (67.5%), followed by White (17.5%) and Afrodescendant (13.3%). The most common comorbidities were hypertension (61.8%), previous venous thromboembolism episodes (31.3%), dyslipidemia (30.6%), and diabetes mellitus (21.5%). Warfarin was the predominant anticoagulant (84%), followed by apixaban (4.9%) and dabigatran (4.2%). Bleeding was the primary indication for reversal (92.4%), while surgical needs accounted for 7.6% of cases. The most used reversal agents were vitamin K (75%) and prothrombin complex concentrates (27.1%). Hospitalization was required in 82% of cases, with 55.1% admitted to intensive care. The mortality rate was 7.6%. Conclusion Our study is the first multicenter characterization of anticoagulated patients requiring reversal therapy in Colombia. Cardiovascular comorbidities were highly prevalent. Bleeding was the leading indication for reversal, and warfarin the most used anticoagulant, likely reflecting its higher bleeding risk. Limited availability of direct oral anticoagulant-specific reversal agents remains a challenge. High hospitalization and mortality rates underscore the high-risk nature of this population, emphasizing the need for improved access to reversal agents and optimized anticoagulation practices. Further research is warranted.

KW - Anticoagulation

KW - anticoagulation reversal

KW - bleeding

KW - Colombia

KW - surgical procedures

U2 - 10.1016/j.tru.2025.100215

DO - 10.1016/j.tru.2025.100215

M3 - Artículo

SN - 2666-5727

JO - Thrombosis Update

JF - Thrombosis Update

ER -

Characterizing Anticoagulation Reversal Practices in Colombia: Initial Insights from a National Registry

Abstract

Centers and Institutes Mederi

UN SDGs

Access to Document

Projects

Colombian Registry of Anticoagulation Clinics and the Use of Reversal Agents

Cite this