Management of bleeding or urgent interventions in patients treated with direct oral anticoagulants: 2017 recommendations for Poland

Pol Arch Intern Med. 2017 May 31;127(5):343-351. doi: 10.20452/pamw.3995. Epub 2017 Mar 15.

Abstract

Direct oral anticoagulants (DOACs) such as apixaban, dabigatran, edoxaban, and rivaroxaban are mainly used in the prevention of thromboembolic complications in patients with atrial fibrillation (AF) and in the treatment of venous thromboembolism. As compared with vitamin K antagonists (VKAs), they are characterized by at least similar efficacy and better safety profiles, especially with respect to intracranial hemorrhages. Moreover, they are more convenient therapeutic agents. The 2016 European Society of Cardiology guidelines clearly favor DOACs over VKAs in patients with AF. However, DOAC therapy is also associated with the risk of bleeding complications. The aim of this review was to provide recommendations for the management of bleeding complications during DOAC therapy in the Polish setting. The recommendations were based on the most important documents concerning this issue and were developed by representatives of different medical specialties. Experience in managing cases of bleeding on DOAC therapy is still limited. Therefore, we hope that this publication will be helpful in everyday clinical practice and that it will be useful for developing in‑hospital recommendations for the management of patients with DOAC‑related bleeding.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Atrial Fibrillation / drug therapy
  • Disease Management*
  • Hemorrhage / chemically induced*
  • Hemorrhage / therapy
  • Humans
  • Practice Guidelines as Topic*
  • Venous Thromboembolism / drug therapy

Substances

  • Anticoagulants