title: New oral anticoagulant-induced bleeding: clinical presentation and management.
abstract: Bleeding is a significant complication of anticoagulant therapy. With the emergence of new oral anticoagulants (NOACs; ie, direct factor IIa or Xa inhibitors), this risk is further compounded by the lack of validated reversal strategies for these agents. Emerging postmarketing evidence suggests that the bleeding risks are in line with results observed in head-to-head clinical trials of NOACs versus traditional anticoagulants. Several guidelines have recommended the use of hemostatic agents for NOAC reversal in patients with life-threatening bleeding. Ultimately, adequately powered studies will be crucial for full assessment of the effectiveness and safety of any proposed reversal strategies.
authors.affiliation: Duke University School of Medicine, Divisions of Cardiothoracic Anesthesiology and Critical Care, Duke University Hospital, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: jerrold.levy@duke.edu.
authors.forename: Jerrold H
authors.initials: JH
authors.lastname: Levy
authors.affiliation: Faculty of Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105AZ, The Netherlands.
authors.forename: Marcel
authors.initials: M
authors.lastname: Levi
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects; D019317:Evidence-Based Medicine; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D012306:Risk
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors
keywords: Anticoagulation; Bleeding; Hemorrhage; New oral anticoagulants; Reversal; Safety