Manejo de hemorragia asociada a anticoagulantes orales directos: estado actual de las estrategias de reversión / Management of bleeding associated with direct oral anticoagulants: update on reversal strategies
Rev. méd. Chile
;
147(1): 73-82, 2019. tab, graf
Article
in Spanish
| LILACS
| ID: biblio-991375
ABSTRACT
Direct oral anticoagulants (DOACs), including the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban and edoxaban have at least comparable efficacy as vitamin K antagonists along with a better safety profile, reflected by a lower incidence of intracranial hemorrhage. Specific reversal agents have been developed in recent years. Namely, idarucizumab, a specific antidote for dabigatran, is currently approved in most countries. Andexanet, which reverses factor Xa inhibitors, has been recently approved by the FDA, and ciraparantag, a universal antidote targeted to reverse all DOACs, is still under investigation. In this review we provide an update on the pharmacology of DOACs, the risk of hemorrhagic complications associated with their use, the measurement of their anticoagulant effect and the reversal strategies in case of DOAC-associated bleeding.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Blood Coagulation Factors
/
Antithrombins
/
Antibodies, Monoclonal, Humanized
/
Hemorrhage
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2019
Type:
Article
Affiliation country:
Canada
/
Chile
Institution/Affiliation country:
Hospital Guillermo Grant Benavente/CL
/
Pontificia Universidad Católica de Chile/CL
/
Queen's University/CA
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