Major bleeding with old and novel oral anticoagulants: How to manage it. Focus on general measures

Stefania Angela Di Fusco, Fabiana Lucà, Manuela Benvenuto, Annamaria Iorio, Damiana Fiscella, Fabrizio D'Ascenzo, Andrea Madeo, Furio Colivicchi, Andrea Di Lenarda, Michele Massimo Gulizia
International Journal of Cardiology 2018 October 1, 268: 80-84
In the last decade, the introduction of non-vitamin K antagonist oral anticoagulants (NOACs) in clinical practice has changed the therapeutic landscape in the prevention of thromboembolic events. Although NOACs compared to vitamin K antagonists (VKAs) have demonstrated a similar or slightly lower rate of major bleeding and a lower rate of intracranial or fatal bleeding, hemorrhaging still represents the main adverse effect of anticoagulant treatment. This review reports data on the rates of major bleeding with old and new oral anticoagulants. It analyses laboratory tests that can be used to assess the intensity of anticoagulation in patients treated with oral anticoagulants and discusses general measures to implement in managing major bleeding.

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