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Prothrombotic Rebound After Discontinuation of Direct Oral Anticoagulants Therapy: A Systematic Review

Marta Frydrych1, Maciej Janeczek2, Agata Małyszek2

  • 1Anaesthesiology and Intensive Care Unit, Sokolowski Specialist Hospital in Walbrzych, Sokolowski 4, 58-309 Walbrzych, Poland.

Journal of Clinical Medicine
|November 9, 2024
PubMed

Insights

Stopping direct oral anticoagulants (DOACs) may increase the risk of thrombotic events. Further research is needed to confirm this hypercoagulability rebound phenomenon after DOAC discontinuation.

Area of Science:

  • Pharmacology
  • Cardiology
  • Hematology

Background:

  • Anticoagulation management, including holding therapy, is common for surgical bleeding risk or acute bleeding.
  • Direct oral anticoagulants (DOACs) are widely used for thromboprophylaxis and treatment.

Purpose of the Study:

  • To systematically review the literature on hypercoagulability and rebound phenomena after discontinuing direct oral anticoagulants (DOACs).

Main Methods:

  • A systematic literature review following PRISMA guidelines was performed.
  • Searched PubMed/MEDLINE, Cochrane, and Google Scholar for studies on DOAC discontinuation and hypercoagulability.
  • Analyzed 16 case reports and 14 original research articles.

Main Results:

  • The review identified a potential association between stopping DOAC therapy and an increased risk of thrombotic events.
  • Evidence suggests a possible hypercoagulability rebound phenomenon upon DOAC cessation.

Conclusions:

  • Cessation of DOAC therapy may be linked to an elevated risk of thrombotic events.
  • Further investigation is required to confirm the incidence and risk of rebound phenomena after DOAC discontinuation.

Keywords:
DOACsantithrombotic therapyapixabandabigatranedoxabanhypercoagulabilityprothrombotic reboundrivaroxaban

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