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Managing reversal o...
Managing reversal of direct oral anticoagulants in emergency situations Anticoagulation Education Task Force White Paper
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- Ageno, Walter (author)
- University of Insubria, Italy
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- Buller, Harry R. (author)
- Academic Medical Centre, Netherlands
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- Falanga, Anna (author)
- Hospital Papa Giovanni XXIII, Italy; Hospital Papa Giovanni XXIII, Italy
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- Hacke, Werner (author)
- Heidelberg University, Germany
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- Hendriks, Jeroen (author)
- Linköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,University of Adelaide, Australia
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- Lobban, Trudie (author)
- Arrhythmia Alliance and AF Assoc, England
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- Merino, Jose (author)
- University of La Paz, Spain
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- Milojevic, Ivan S. (author)
- Gen Hospital Cuprija, Serbia
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- Moya, Francisco (author)
- Vithas Xanit Int Hospital, Spain
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- Bart van der Worp, H. (author)
- University of Medical Centre Utrecht, Netherlands
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- Randall, Gary (author)
- SAFE, England
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- Tsioufis, Konstantinos (author)
- University of Athens, Greece
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- Verhamme, Peter (author)
- University of Leuven, Belgium
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- John Camm, A. (author)
- St Georges University of London, England; Imperial Coll, England
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(creator_code:org_t)
- SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN, 2016
- 2016
- English.
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In: Thrombosis and Haemostasis. - : SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN. - 0340-6245 .- 2567-689X. ; 116:6, s. 1003-1010
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Anticoagulation is the cornerstone of prevention and treatment of venous thromboembolism (VTE) and stroke prevention in patients with atrial fibrillation (AF). However, the mechanisms by which anticoagulants confer therapeutic benefit also increase the risk of bleeding. As such, reversal strategies are critical. Until recently, the direct oral anticoagulants (DOACs) dabigatran, rivaroxaban, apixaban, and edoxaban lacked a specific reversal agent. This report is based on findings from the Anticoagulation Education Task Force, which brought together patient groups and professionals representing different medical specialties with an interest in patient safety and expertise in AF, VTE, stroke, anticoagulation, and reversal agents, to discuss the current status of anticoagulation reversal and fundamental changes in management of bleeding associated with DOACs occasioned by the approval of idarucizumab, a specific reversal agent for dabigatran, as well as recent clinical data on specific reversal agents for factor Xa inhibitors. Recommendations are given for when there is a definite need for a reversal agent (e.g. in cases of life-threatening bleeding, bleeding into a closed space or organ, persistent bleeding despite local haemostatic measures, and need for urgent interventions and/or interventions that carry a high risk for bleeding), when reversal agents may be helpful, and when a reversal agent is generally not needed. Key stakeholders who require 24-7/around-the-clock access to these agents vary among hospitals; however, from a practical perspective the emergency department is recommended as an appropriate location for these agents. Clearly, the advent of new agents requires standardised protocols for treating bleeding on an institutional level.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Anticoagulation; venous thromboembolism; stroke prevention; atrial fibrillation; reversal agents
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ageno, Walter
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Buller, Harry R.
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Falanga, Anna
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Hacke, Werner
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Hendriks, Jeroen
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Lobban, Trudie
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show more...
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Merino, Jose
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Milojevic, Ivan ...
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Moya, Francisco
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Bart van der Wor ...
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Randall, Gary
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Tsioufis, Konsta ...
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Verhamme, Peter
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John Camm, A.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Thrombosis and H ...
- By the university
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Linköping University