Post-endoscopic mucosal resection bleeding occurred in 10.5% of patients using direct oral anticoagulants, with significant variability in plasma levels and FXa activity.
Does high anticoagulant ability in DOAC users increase the risk of post-EMR delayed bleeding in patients with colorectal neoplasms?
DOAC users with high anticoagulant activity, as measured by FXa activity and plasma levels, are at a significantly higher risk of delayed bleeding following endoscopic mucosal resection of colorectal neoplasms.
Absolute Event Rate: 0% vs 0%
UNLABELLED: Anticoagulant effects of direct oral anticoagulants (DOACs) are influenced by their plasma levels and anti-factor Xa (FXa) activity. Delayed bleeding is a major adverse event associated with endoscopic mucosal resection (EMR) of colorectal neoplasms. However, the association between post-EMR bleeding and pharmacodynamics in patients taking DOAC remains unknown. This study investigated the association between pharmacological risk factors and delayed bleeding in patients receiving DOAC. This multicenter prospective trial in Japan evaluated the incidence of post-EMR delayed bleeding in DOAC users between April 2018 and May 2022 and determined the association of post-EMR delayed bleeding with plasma levels and FXa activity. The incidence of post-EMR delayed bleeding was 10.5% (95% confidence interval CI: 5.3%-18.0%). There were large individual differences in plasma levels and FXa activity for each DOAC. At the trough and T SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-025-33056-w.
Murata et al. (Mon,) reported a other. Post-endoscopic mucosal resection bleeding occurred in 10.5% of patients using direct oral anticoagulants, with significant variability in plasma levels and FXa activity.