Related Experiment Video

Updated: Aug 13, 2025

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
08:13

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice

Published on: September 30, 2021

6.4K

Gastrointestinal bleeding during anticoagulation with direct oral anticoagulants compared to vitamin K antagonists

Kanchan Dongre1, Yasmin Schmid2, Luana Nussbaum2

  • 1Department of Patient Safety, Medical Directorate, University Hospital Basel, Switzerland.

Global Cardiology Science & Practice
|January 20, 2023
PubMed

Insights

Patients on vitamin K antagonists (VKAs) have more gastrointestinal bleeding (GIB) risk factors than those on direct oral anticoagulants (DOACs). DOACs are linked to early GIB, requiring vigilance in the initial months of treatment.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Internal Medicine

Background:

  • Oral anticoagulants, including vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs), increase the risk of gastrointestinal bleeding (GIB).
  • Understanding the comparative risk profiles of VKAs and DOACs in GIB is crucial for patient safety.

Purpose of the Study:

  • To compare gastrointestinal bleeding (GIB) cases associated with VKAs and DOACs.
  • To analyze differences in risk factors, timing, severity, and outcomes of GIB between VKA and DOAC users.

Main Methods:

  • Retrospective analysis of 248 patients with GIB treated at a Swiss university hospital between 2012 and 2018.
  • Comparison of patient demographics, comorbidities, medication use, bleeding risk scores (HAS-BLED), INR levels, and GIB characteristics between VKA and DOAC groups.

Main Results:

  • VKA patients exhibited a higher propensity for risk factors like comorbidities and interacting medications (higher HAS-BLED scores).
  • Gastrointestinal bleeding occurred earlier in the DOAC group (median 3 months) compared to the VKA group (median 23.5 months).
  • Amiodarone co-medication was significantly associated with GIB in the DOAC group.

Conclusions:

  • While VKA users have more pre-existing risk factors for GIB, DOACs are associated with earlier onset GIB.
  • Increased vigilance is recommended during the initial months of DOAC therapy due to the risk of early GIB.
  • Amiodarone co-administration may represent a specific risk factor for GIB in patients taking DOACs.

More Related Videos

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

13.8K
A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis10:26

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

17.3K

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K
Disorders of Hemostasis01:24

Disorders of Hemostasis

Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
1.0K
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
821
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
16
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
113
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
18