Emergency care of patients receiving non-vitamin K antagonist oral anticoagulants. (April 2018)

• Record Type: Journal Article
• Authors: Eikelboom, J.W.; Kozek-Langenecker, S.; Exadaktylos, A.; Batorova, A.; Boda, Z.; Christory, F.; Gornik, I.; Kėkštas, G.; Kher, A.; Komadina, R.; Koval, O.; Mitic, G.; Novikova, T.; Pazvanska, E.; Ratobilska, S.; Sütt, J.; Winder, A.; Zateyshchikov, D.
• Is Part Of: British journal of anaesthesia. Volume 120:Number 4(2018)
• Page Start: 645
• Page End: 656
• Publication Date: 2018-04
• Subjects: anticoagulants -- coagulation monitoring -- emergencies -- haemorrhage -- reversal; Anesthesiology -- Periodicals; Anesthesia -- Periodicals; 617.9605
• DOI: 10.1016/j.bja.2017.11.082
• Languages: English
• ISSNs: 0007-0912

Abstract

Abstract: Non-vitamin K antagonist oral anticoagulants (NOACs), which inhibit thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban, edoxaban) have been introduced in several clinical indications. Although NOACs have a favourable benefit-risk profile and can be used without routine laboratory monitoring, they are associated–as any anticoagulant–with a risk of bleeding. In addition, treatment may need to be interrupted in patients who need surgery or other procedures. The objective of this article, developed by a multidisciplinary panel of experts in thrombosis and haemostasis, is to provide an update on the management of NOAC-treated patients who experience a bleeding episode or require an urgent procedure. Recent advances in the development of targeted reversal agents are expected to help streamline the management of NOAC-treated patients in whom rapid reversal of anticoagulation is required.