Cardiology Letters 2025, 34(4):235-243

Anticoagulant therapy in a patient with thrombocytopenia

Tomáš Guman¹, Juraj Sokol², František Nehaj^{3, 5}, Juraj Chudej², Lenka Lisá², Ľudmila Lineková², Richard Jusko², Ivan Kecskés^{2, 4}, Ivana Plameňová²

¹ Klinika hematológie a onkohematológie, Lekárska fakulta v Košiciach, Univerzita Pavla Jozefa Šafárika v Košiciach

² Klinika hematológie a transfuziológie, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave

³ Klinika arytmológie, Lekárska fakulta v Bratislave, Univerzita Komenského v Bratislave

⁴ Onkologické centrum, Univerzitná nemocnica Martin, Martin

⁵ Oddelenie arytmológie a kardiostimulácie, Národný ústav srdcových a cievnych chorôb, a. s., Bratislava, Slovenská republika

Anticoagulant therapy in patients with thrombocytopenia represents a clinical challenge that requires careful balancing of bleeding and thrombotic risks. In clinical practice, a minimum platelet count threshold is often taken into account when deciding on anticoagulation; if the count falls below this level, treatment is usually considered too risky. However, this approach is not supported by strong clinical evidence. Thrombocytopenia comprises a heterogeneous group of disorders that can lead to an increased bleeding tendency, yet these conditions do not preclude the development of transient or permanent prothrombotic states that may require prophylactic or therapeutic anticoagulation. In this review, we summarize the current knowledge on anticoagulant therapy in patients with thrombocytopenia.

Keywords: anticoagulant therapy; management; thrombocytopenia

Published: April 1, 2025  Show citation