Gastrointestinal bleeding secondary to the new anticoagulants

Neena Susan Abraham, Jennifer L. Horsley-Silva

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: To quantify direct oral anticoagulants (DOACs) related gastrointestinal bleeding (GIB), characterize patients at greatest risk and provide a pragmatic approach for the management of these drugs. This review will also summarize risk-management strategies and highlight evolving areas of clinical knowledge. RECENT FINDINGS: DOACs permit anticoagulation with predictable dosing without the need for routine serum monitoring. Since their availability on the market, they have quickly emerged as a popular alternative for patients requiring short-term and lifelong anticoagulation. However, they are associated with an increased risk of GIB when compared with warfarin; thus, gastroenterologists must be prepared to manage DOAC-related GIB and prevent drug-related complications. This review will focus on acute and elective periendoscopic DOAC management, high-risk clinical groups for DOAC-related GIB, quantification of DOAC levels, use of reversal agents and minimization of thromboembolic risk associated with temporary interruption. SUMMARY: This review will highlight pragmatic strategies for the treatment of DOAC-related bleeding and the prevention of postendoscopic DOAC bleeding. It will address new and evolving areas of periendoscopic management and identify knowledge gaps requiring further research to inform clinical practice.

Original languageEnglish (US)
JournalCurrent Opinion in Gastroenterology
DOIs
StateAccepted/In press - Sep 14 2016

Fingerprint

Anticoagulants
Hemorrhage
Risk Management
Knowledge Management
Warfarin
Pharmaceutical Preparations
Serum
Research

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Gastrointestinal bleeding secondary to the new anticoagulants. / Abraham, Neena Susan; Horsley-Silva, Jennifer L.

In: Current Opinion in Gastroenterology, 14.09.2016.

Research output: Contribution to journalArticle

@article{b8dc998c719e4abbbd03ec32e7e62307,
title = "Gastrointestinal bleeding secondary to the new anticoagulants",
abstract = "PURPOSE OF REVIEW: To quantify direct oral anticoagulants (DOACs) related gastrointestinal bleeding (GIB), characterize patients at greatest risk and provide a pragmatic approach for the management of these drugs. This review will also summarize risk-management strategies and highlight evolving areas of clinical knowledge. RECENT FINDINGS: DOACs permit anticoagulation with predictable dosing without the need for routine serum monitoring. Since their availability on the market, they have quickly emerged as a popular alternative for patients requiring short-term and lifelong anticoagulation. However, they are associated with an increased risk of GIB when compared with warfarin; thus, gastroenterologists must be prepared to manage DOAC-related GIB and prevent drug-related complications. This review will focus on acute and elective periendoscopic DOAC management, high-risk clinical groups for DOAC-related GIB, quantification of DOAC levels, use of reversal agents and minimization of thromboembolic risk associated with temporary interruption. SUMMARY: This review will highlight pragmatic strategies for the treatment of DOAC-related bleeding and the prevention of postendoscopic DOAC bleeding. It will address new and evolving areas of periendoscopic management and identify knowledge gaps requiring further research to inform clinical practice.",
author = "Abraham, {Neena Susan} and Horsley-Silva, {Jennifer L.}",
year = "2016",
month = "9",
day = "14",
doi = "10.1097/MOG.0000000000000310",
language = "English (US)",
journal = "Current Opinion in Gastroenterology",
issn = "0267-1379",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Gastrointestinal bleeding secondary to the new anticoagulants

AU - Abraham, Neena Susan

AU - Horsley-Silva, Jennifer L.

PY - 2016/9/14

Y1 - 2016/9/14

N2 - PURPOSE OF REVIEW: To quantify direct oral anticoagulants (DOACs) related gastrointestinal bleeding (GIB), characterize patients at greatest risk and provide a pragmatic approach for the management of these drugs. This review will also summarize risk-management strategies and highlight evolving areas of clinical knowledge. RECENT FINDINGS: DOACs permit anticoagulation with predictable dosing without the need for routine serum monitoring. Since their availability on the market, they have quickly emerged as a popular alternative for patients requiring short-term and lifelong anticoagulation. However, they are associated with an increased risk of GIB when compared with warfarin; thus, gastroenterologists must be prepared to manage DOAC-related GIB and prevent drug-related complications. This review will focus on acute and elective periendoscopic DOAC management, high-risk clinical groups for DOAC-related GIB, quantification of DOAC levels, use of reversal agents and minimization of thromboembolic risk associated with temporary interruption. SUMMARY: This review will highlight pragmatic strategies for the treatment of DOAC-related bleeding and the prevention of postendoscopic DOAC bleeding. It will address new and evolving areas of periendoscopic management and identify knowledge gaps requiring further research to inform clinical practice.

AB - PURPOSE OF REVIEW: To quantify direct oral anticoagulants (DOACs) related gastrointestinal bleeding (GIB), characterize patients at greatest risk and provide a pragmatic approach for the management of these drugs. This review will also summarize risk-management strategies and highlight evolving areas of clinical knowledge. RECENT FINDINGS: DOACs permit anticoagulation with predictable dosing without the need for routine serum monitoring. Since their availability on the market, they have quickly emerged as a popular alternative for patients requiring short-term and lifelong anticoagulation. However, they are associated with an increased risk of GIB when compared with warfarin; thus, gastroenterologists must be prepared to manage DOAC-related GIB and prevent drug-related complications. This review will focus on acute and elective periendoscopic DOAC management, high-risk clinical groups for DOAC-related GIB, quantification of DOAC levels, use of reversal agents and minimization of thromboembolic risk associated with temporary interruption. SUMMARY: This review will highlight pragmatic strategies for the treatment of DOAC-related bleeding and the prevention of postendoscopic DOAC bleeding. It will address new and evolving areas of periendoscopic management and identify knowledge gaps requiring further research to inform clinical practice.

UR - http://www.scopus.com/inward/record.url?scp=84987898733&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84987898733&partnerID=8YFLogxK

U2 - 10.1097/MOG.0000000000000310

DO - 10.1097/MOG.0000000000000310

M3 - Article

C2 - 27636303

AN - SCOPUS:84987898733

JO - Current Opinion in Gastroenterology

JF - Current Opinion in Gastroenterology

SN - 0267-1379

ER -