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Reversal of oral factor Xa inhibitors by prothrombin complex concentrates: a re‐appraisal
Author(s) -
Dzik W. H.
Publication year - 2015
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12949
Subject(s) - prothrombin complex , medicine , rivaroxaban , dabigatran , prothrombin complex concentrate , oral anticoagulant , intensive care medicine , warfarin , atrial fibrillation , coagulation
Summary Oral factor Xa inhibitors are an attractive class of anticoagulants expected to have broad application. Rapid and reliable reversal of the anticoagulant effect is important for patients with bleeding complications or those in need of urgent reversal for procedures. While no specific reversal agent is yet available, multiple published clinical guidelines suggest that four‐factor prothrombin complex concentrates ( PCC ) should be considered when urgent reversal is desired. This presentation updates prior reviews on this topic ( Crit Care , 17 , 2013, 230; Thromb Haemost , 111 , 2014, 189; J Thromb Thrombolysis , 2015, 39 , 395); and summarizes more recent evidence in human studies indicating that four‐factor PCC s available in North America do not reverse oral factor Xa‐inhibitor anticoagulants. New agents on the horizon appear to be far more promising as therapies for reversal or oral factor Xa inhibitors.