December 19, 2017British Journal of Anaesthesia124 citationsOpen Access
Emergency care of patients receiving non-vitamin K antagonist oral anticoagulants
Key Result
Targeted reversal agents are expected to streamline the emergency management of NOAC-treated patients who experience a bleeding episode or require an urgent procedure.
Structured PICO
P
Population
Patients receiving non-vitamin K antagonist oral anticoagulants (NOACs) who experience a bleeding episode or require an urgent procedure
I
Intervention
Management strategies including targeted reversal agents
Provides an expert update on the emergency management of NOAC-treated patients, emphasizing the emerging role of targeted reversal agents.
Abstract
Non-vitamin K antagonist oral anticoagulants (NOACs), which inhibit thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban, edoxaban) have been introduced in several clinical indications. Although NOACs have a favourable benefit-risk profile and can be used without routine laboratory monitoring, they are associated-as any anticoagulant-with a risk of bleeding. In addition, treatment may need to be interrupted in patients who need surgery or other procedures. The objective of this article, developed by a multidisciplinary panel of experts in thrombosis and haemostasis, is to provide an update on the management of NOAC-treated patients who experience a bleeding episode or require an urgent procedure. Recent advances in the development of targeted reversal agents are expected to help streamline the management of NOAC-treated patients in whom rapid reversal of anticoagulation is required.