Title: Monitoring and reversal strategies for new oral anticoagulants
Authors: Vanden Daelen, Sophie ×
Peetermans, Marijke
Vanassche, Thomas
Verhamme, Peter
Vandermeulen, Erik #
Issue Date: Jan-2015
Publisher: Expert Reviews Ltd.
Series Title: Expert Review of Cardiovascular Therapy vol:13 issue:1 pages:95-103
Abstract: Thrombin inhibitor dabigatran and factor Xa inhibitors rivaroxaban, apixaban and edoxaban form a new class of non-vitamin K antagonist oral anticoagulants and have been extensively studied in patients with venous thromboembolism and atrial fibrillation. They offer anticoagulation that is as effective and at least as safe compared to warfarin without the need for routine laboratory monitoring; however, no reversal strategies are currently validated in case of a non-vitamin K antagonist oral anticoagulant-associated bleed. In emergency situations, laboratory drug measurement and well-defined management for non-vitamin K antagonist oral anticoagulant-induced hemorrhage may improve clinical outcome. In this review, the merits and limitations of the routine coagulation tests and some of the more specific laboratory assays are compared. Furthermore, prohemostatic measures are reviewed and the recommended strategies in case of bleeding are summarized. Specific reversal agents are currently under development (idarucizumab for dabigatran, andexanet alfa for Xa inhibitors, and PER977 for both Xa- and thrombin inhibitors), which will facilitate clinical management of severe bleeding and emergency surgery.
ISSN: 1477-9072
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Anesthesiology and Algology
Molecular and Vascular Biology
× corresponding author
# (joint) last author

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