Acute management of bleeding in patients on novel oral anticoagulants | Zendy

Deborah Siegal | Zendy; Mark Crowther | Zendy

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Acute management of bleeding in patients on novel oral anticoagulants

Author(s) -

Deborah Siegal,

Mark Crowther

Publication year - 2012

Publication title -

european heart journal

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 4.336

H-Index - 293

eISSN - 1522-9645

pISSN - 0195-668X

DOI - 10.1093/eurheartj/ehs408

Subject(s) - medicine , rivaroxaban , dabigatran , apixaban , atrial fibrillation , anticoagulant , intensive care medicine , venous thromboembolism , oral anticoagulant , discovery and development of direct thrombin inhibitors , drug , warfarin , thrombin , thrombosis , pharmacology , platelet

Novel oral anticoagulants that directly inhibit thrombin (dabigatran) or factor Xa (rivaroxaban, apixaban) are currently available for prevention of venous thromboembolism (VTE) after orthopaedic surgery, treatment of acute VTE, and prevention of arterial thromboembolism in non-valvular atrial fibrillation. These agents offer advantages over VKAs, including rapid onset, shorter half-lives, fewer drug interactions, and lack of need for routine monitoring. However, there are no established agents to reverse their anticoagulant effect. We review the risk of bleeding with the novel oral anticoagulants and the limitations of conventional coagulation assays for measuring anticoagulant effect. We provide an approach to the management of patients with bleeding complications with evidence for various interventions for reversal, where available.

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