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Major bleeding complications in patients treated with direct oral anticoagulants: One-year observational study in a

L Deville1, M Konan2, A Hij3

  • 1Service de pharmacie, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 1, avenue Claude-Vellefaux, 75010 Paris, France.

Current Research in Translational Medicine
|October 22, 2016
PubMed

Insights

Direct oral anticoagulants (DOACs) offer benefits but can cause severe bleeding. Managing these bleeding complications is challenging due to the lack of specific antidotes, necessitating careful risk-benefit assessment.

Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Hemorrhagic Complications

Background:

  • Direct oral anticoagulants (DOACs) are increasingly prescribed for venous thromboembolism and stroke prevention in atrial fibrillation.
  • DOACs offer advantages over vitamin K antagonists (VKAs) but pose bleeding risks.
  • Managing DOAC-associated bleeding is complex due to the absence of specific reversal agents.

Purpose of the Study:

  • To report and discuss major hemorrhagic complications associated with DOAC therapy.
  • To highlight the challenges in managing DOAC-induced bleeding.
  • To emphasize the importance of risk-benefit assessment before initiating DOACs.

Main Methods:

  • Retrospective case series analysis.
  • Pharmacological surveillance data from Saint-Louis University Hospital (Paris, France).
  • Review of five cases of major hemorrhagic complications over one year.

Main Results:

  • Five cases of major hemorrhagic complications under DOAC therapy were identified.
  • Treatment of these severe bleeding events presented significant clinical challenges.
  • The study underscores the complexity of managing DOAC-related hemorrhages.

Conclusions:

  • DOACs, despite their benefits, are associated with potentially severe bleeding.
  • Effective management strategies for DOAC-induced bleeding complications are crucial.
  • A thorough risk-benefit evaluation is essential for safe DOAC prescription.

Keywords:
ContraindicationsDirect oral anticoagulantsMajor hemorrhagePrecautions for useRisk/benefit ratio

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