Should we monitor the direct oral anticoagulants?

Diep, Robert; García, David

doi:10.1007/s11239-020-02119-2

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…In this regard a recent study suggests that the activity of anticoagulation measured by specific DOAC plasma levels on admission is associated with stroke severity (53), and some studies support the reliability of DOAC determination (54,55) especially in patients with acute ischemic stroke (56,57). However, the ideal test is not yet widely available, and more studies are needed to guide future treatment decisions (58,59).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Anticoagulation in Secondary Ischemic Stroke Prevention: The Prospective Multicenter RESTAIC Registry

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Long-Term Anticoagulation in Secondary Ischemic Stroke Prevention: The Prospective Multicenter RESTAIC Registry

et al. 2020

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“…40- 43 However, DOACs should be used with caution in the cases of suspected malabsorption and bowel ischemia, which are conditions that could occur in SVT. 44 Furthermore, DOACs may carry a non--negligible risk of gastrointestinal bleeding as compared with warfarin in specific populations, and their use is not allowed in patients with liver cirrhosis and a Child-Pugh class B (rivaroxaban) or C (all DOACs), which is often associated with SVT. 2,3,45, 46 On the other hand, several meta -analyses of observational studies showed a similar effectiveness and a lower bleeding risk for DOACs, as compared with VKAs, in patients with cirrhosis and a Child-Pugh class A or B, even when esophageal varices were present.…”

Section: Medical Treatment Of Acute Splanchnic Vein Thrombosismentioning

confidence: 99%

How to treat patients with splanchnic vein thrombosis: recent advances

Valeriani¹,

Menichelli²,

Palumbo³

et al. 2023

Polish Archives of Internal Medicine

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of splanchnic vein thrombosis 1 thanks to vein recanalization. Recent data support this hypothesis and show that the incidence of both recurrent VTE and major bleedings was the lowest during anticoagulation, increased after treatment discontinuation, and was the highest in never -treated patients. 4 These results were confirmed even in specific subgroups of patients at a higher risk, such as those with solid cancer, liver cirrhosis, and incidentally detected SVT. 4 Despite the fact that several observational studies and a few randomized controlled trials (RCTs) have been conducted over the last years in the attempt to fill the knowledge gap, therapeutic management of SVT still remains heterogeneous, current treatment recommendations vary widely across clinical practice guidelines, and every day clinicians have to struggle with the decision of which patients should be treated and which anticoagulant regimen should be administered. 1,5-9 Introduction Splanchnic vein thrombosis (SVT) is generally defined as an unusual-site vein thrombosis and includes portal, mesenteric, or splenic vein thrombosis, and the Budd-Chiari syndrome (BCS). 1 SVT is a relatively rare disease, with incidence rates at least 25 times lower than those of usual-site venous thromboembolism (VTE). 2 Roughly one-third of the cases are incidentally detected during abdominal imaging performed for other reasons, and liver cirrhosis and solid cancer represent the main risk factors for SVT development. 2,3While the beneficial effects of anticoagulation on vein recanalization and thrombus progression or recurrence may be expected, its safety profile may be uncertain given the increased perceived risk of portal hypertension-related bleeding. However, anticoagulation improves splanchnic hemodynamics and may reduce the said risk

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“…As is the case with other NOACs (Xa inhibitors apixaban and edoxaban, and a direct thrombin inhibitor dabigatran), rivaroxaban is favored over VKAs for simplicity of use that does not require constant monitoring of the coagulation cascade and, generally, for a lower risk of major bleedings ( 4 ). However, exposure to and anticoagulant effect of rivaroxaban is affected by age, sex, body weight, hepatic and renal function, concomitant diseases and treatments ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%