Pharmacological reversal of the direct oral anticoagulants-A comprehensive review of the literature.

摘要: The direct oral anticoagulants (DOACs) are used for stroke prevention in atrial fibrillation (SPAF) and the treatment of venous thromboembolic disease (VTE). Although DOAC-associated bleeding events less frequent as compared to vitamin K antagonists, there is significant concern surrounding physicians' ability evaluate manage when it does occur. Idarucizumab a specific reversal agent dabigatran choice setting major or urgent surgery/procedures. There no commercially available agents Xa inhibitors. they have not been rigorously studied DOAC-treated patients requiring anticoagulant reversal, limited evidence from vitro studies, animal models, human volunteer studies (in vivo vitro) case series suggest that coagulation factor replacement with prothrombin complex concentrate (PCC) activated PCC (FEIBA) may contribute hemostasis. However, safety efficacy these optimal dosing strategies remain uncertain.