Key result
Prothrombin complex concentrate for reversal of direct oral anticoagulants showed no significant difference in in-hospital mortality (9.5% vs 5.5%, p=0.218) compared to vitamin K antagonist reversal.
Why the study?
PCC is widely used for DOAC reversal, but indications, clinical characteristics, and patient outcomes might differ compared to the well-established use of PCC for VKA reversal.
Does prothrombin complex concentrate for reversal of DOACs result in different clinical outcomes compared to reversal of VKAs in emergency department patients?
Population
346 patients given PCC for reversal of DOAC (n = 74) or VKA (n = 272)
Comparison
DOAC reversal with PCC vs VKA reversal with PCC
Design
Cohort study
Authors
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Similar mortality with PCC reversal of DOACs versus VKAs supports real-world use; leaves open confirmation by randomized ED trials.
Cohort (n=346)
No
Does prothrombin complex concentrate for reversal of DOACs result in different clinical outcomes compared to reversal of VKAs in emergency department patients?
Absolute Event Rate: 9.5% vs 5.5%
p-value: p=0.218
Reversal of DOACs with PCC in clinical practice yields similar in-hospital mortality and length of stay compared to VKA reversal, despite differences in bleeding sources and adjunctive treatments.
Müller et al. (2019) conducted a cohort in Oral anticoagulant reversal (n=346). Prothrombin complex concentrate (PCC) for DOAC reversal vs. Prothrombin complex concentrate (PCC) for VKA reversal was evaluated on In-hospital mortality (p=0.218). Prothrombin complex concentrate for reversal of direct oral anticoagulants showed no significant difference in in-hospital mortality (9.5% vs 5.5%, p=0.218) compared to vitamin K antagonist reversal.
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