Project Grant R01HL187467

The National Heart, Lung, and Blood Institute (NHLBI), a component of the Department of Health and Human Services National Institutes of Health, awarded Brigham & Women's Hospital Inc. $894,718 on August 15, 2026, under the Cardiovascular Diseases Research program (CFDA 93.837) to conduct research on optimal prescribing of oral anticoagulants in patients with venous thromboembolism and cirrhosis.

The research addresses a critical evidence gap in anticoagulation therapy for cirrhosis patients with VTE. More than 60 percent of patients with cirrhosis and VTE remain untreated due to concerns about severe bleeding, uncertainties regarding warfarin effectiveness in the setting of cirrhosis-related coagulopathy, and limited safety data on direct oral anticoagulants given their variable liver metabolism profiles. All major randomized controlled trials of anticoagulation in VTE have excluded cirrhosis patients, and prior observational studies were too small to provide meaningful estimates. The project will develop a prospective, sequential target trial emulation framework to evaluate oral anticoagulation therapy in cirrhosis and VTE patients, incorporate novel phenotyping algorithms for cirrhosis severity and high-risk features, identify predictors and barriers to anticoagulant use, and generate evidence on the comparative effectiveness, safety, and net clinical benefit of oral anticoagulation therapy.

Work is performed in Mission Hill, Massachusetts. The period of performance runs through May 31, 2031. Brigham & Women's Hospital is a subsidiary of Partners Healthcare System Incorporated and operates as a prime recipient on federal research grants with substantial prior funding from NHLBI.