Cessation of direct oral anticoagulant therapy may be associated with an increased risk of thrombotic events, suggesting a potential prothrombotic rebound phenomenon.
Systematic Review
Does the discontinuation of direct oral anticoagulants (DOACs) increase the risk of hypercoagulability and thrombotic events?
Discontinuation of DOAC therapy may lead to a prothrombotic rebound and increased risk of thrombotic events, highlighting the need for careful management during anticoagulation interruptions.
Background/Objectives: The practice of holding anticoagulation is a relatively common approach, with the aim of either preventing excessive bleeding in preparation for surgical procedures or managing acute bleeding episodes. Methods: To assess the relationship between the discontinuation of direct oral anticoagulants (DOACs) therapy and the condition of hypercoagulability, a systematic review of the literature was conducted, following PRISMA guidelines, in PubMed/MEDLINE, Cochrane, and Google Scholar. These databases were searched for all publications that described a rebound phenomenon or hypercoagulability state after DOACs discontinuation. Results: A total of 1494 articles were selected from searched databases, and 29 were eligible. A final total of 16 case reports and 14 original research articles were subjected to analysis. Conclusions: The results of this study indicate that the cessation of DOAC therapy may be associated with an increased risk of thrombotic events. More studies are required to ascertain whether DOACs treatment cessation can be linked to rebound phenomena associated with thromboembolic events. This will provide the data needed to determine the incidence and risk of this phenomenon.
Frydrych et al. (Sun,) conducted a systematic review in Hypercoagulability after DOAC discontinuation. Discontinuation of direct oral anticoagulants (DOACs) was evaluated on Rebound phenomenon or hypercoagulability state. Cessation of direct oral anticoagulant therapy may be associated with an increased risk of thrombotic events, suggesting a potential prothrombotic rebound phenomenon.
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