Скачать или смотреть Reversal of DOACs in Critical Bleeding and Urgent Procedures: Latest Evidence and Insights

New Perspectives on the Reversal of Direct Oral Anticoagulants (DOACs) in Critical Bleeding and Urgent Procedures 🩸💉

Full Article here: Goldin, M.; Tsaftaridis, N.; Jnani, J.; Spyropoulos, A.C. Reversal of Direct Oral Anticoagulants (DOACs) for Critical Bleeding or Urgent Procedures. J. Clin. Med. 2025, 14, 1013. https://doi.org/10.3390/jcm14031013

Direct Oral Anticoagulants (#DOACs) have transformed the management of thrombotic diseases 🫀, offering significant advantages over traditional anticoagulants. However, major bleeding 🚨 or urgent surgical interventions 🏥 demand fast and effective reversal strategies.

📚 Recent Evidence Highlights:

🔹 Specific Reversal Agents (Andexanet Alfa & Idarucizumab)
✅ Superior hemostatic control in life-threatening bleeding, especially intracranial hemorrhage 🧠, and urgent surgeries.
✅ Andexanet alfa (Factor Xa inhibitors: rivaroxaban, apixaban) → linked to lower 30-day mortality vs. PCCs, though with some thrombotic risk ⚠️.
✅ Idarucizumab (dabigatran) → rapid, complete reversal with excellent perioperative outcomes ⏱️.

🔹 Non-Specific Agents (PCCs & Tranexamic Acid)
⚠️ PCCs show inconsistent efficacy for DOAC reversal.
⚠️ Tranexamic acid → no major benefit in hematoma reduction in DOAC-related ICH 🧠.

💡 Key Takeaway:
Specific agents like Andexanet Alfa & Idarucizumab should be first-line therapy for catastrophic DOAC-related bleeding, especially ICH. Clinical pathways targeting a door-to-reversal time of 60 min ⏱️ are essential but remain underutilized.


Hashtags:

#DOACs 🩸 #Anticoagulation 💉 #Reversal ⚕️ #CriticalBleeding 🚨 #ICH 🧠 #Hemostasis 🫀 #AndexanetAlfa #Idarucizumab #EmergencyMedicine 🏥 #MedicalEducation 📚 #ClinicalResearch 🔬 #PatientSafety 🛡️ #HealthcareInnovation 💡