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Bleeding complications of targeted oral anticoagulants: what is the risk?

Michael Levine1, Joshua N Goldstein2

  • 1Department of Emergency Medicine, Section of Medical Toxicology, University of Southern California, Los Angeles, CA; and.

Hematology. American Society of Hematology. Education Program
|February 20, 2015
PubMed

Insights

Target-specific oral anticoagulants (TSOACs) offer alternatives to vitamin K antagonists (VKAs) for preventing blood clots. This review examines major bleeding risks associated with TSOACs, focusing on gastrointestinal and intracranial hemorrhages.

Area of Science:

  • Pharmacology
  • Hematology
  • Clinical Medicine

Background:

  • Vitamin K antagonists (VKAs) are established treatments for thromboembolism prevention.
  • Target-specific oral anticoagulants (TSOACs) represent newer alternatives in clinical practice.
  • Available TSOACs target thrombin or factor Xa.

Purpose of the Study:

  • To review the risks of major bleeding complications associated with TSOACs.
  • To compare bleeding risks between TSOACs and warfarin.
  • To identify common causes of major bleeding with these agents.

Main Methods:

  • Analysis of data from meta-analyses.
  • Review of randomized controlled trials.
  • Examination of observational studies.

Main Results:

  • TSOACs, like VKAs, are associated with bleeding complications.
  • Gastrointestinal and intracranial hemorrhages are highlighted as common major bleeding events.
  • Comparative bleeding risk data between TSOACs and warfarin are discussed.

Conclusions:

  • Understanding TSOAC bleeding risks is crucial for patient safety.
  • Gastrointestinal and intracranial hemorrhages are key concerns with TSOACs.
  • Further research and clinical vigilance are necessary for optimal anticoagulant therapy.

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