Bleeding complications of oral anticoagulant therapy: from ISCOAT to the START Register

On December 12, 2025, I had the honor of delivering a special lecture titled Bleeding Complications of Oral Anticoagulant Therapy: From ISCOAT to the START Register at the 20th Meeting on Bleeding and Thrombosis Care in Castellammare di Stabia, Naples (Italy). This lecture was dedicated to Gualtiero Palareti from Bologna, who sadly passed away on August 8 of the same year. Speaking at this event was a privilege, as Gualtiero was a remarkable figure in hemostasis and thrombosis, both in Italy and internationally. He was also an invaluable teacher to many of us. I took this opportunity to honor his legacy and reflect on his contributions over the past 36 years. In my lecture, I provided a brief history of anticoagulants that underpinned Gualtiero’s work, along with a general overview of the field. Additionally, I shared my personal observations on the Italian Federation of Anticoagulation Clinic and discussed studies conducted by ISCOAT (Italian Study on the Complications of Oral Anticoagulant Therapy) and the START Register, in which Gualtiero Palareti played a pivotal role.