Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke-Reference-Cited by-同舟云学术

Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke

Published:2024-01 Issue: Volume:30 Page:
ISSN:1076-0296
Container-title:Clinical and Applied Thrombosis/Hemostasis
language:en
Short-container-title:Clin Appl Thromb Hemost

Author:

Frol Senta¹²^ORCID,Pretnar Oblak Janja¹²,Šabovič Mišo²³,van Zwam Wim H.⁴⁵,Ntaios George⁶,Lövblad Karl Olof⁷,Gruber Andreas⁸⁹,Kermer Pawel¹⁰¹¹

Affiliation:

1. Department of Vascular Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia

2. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

3. Department of Vascular Disorders, University Medical Center Ljubljana, Ljubljana, Slovenia

4. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands

5. CARIM, School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands

6. Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

7. Department of neurodiagnostic, University Hospital Geneva, Geneva, Switzerland

8. Department of Neurosurgery, Kepler University Hospital Linz, Linz, Austria

9. Johannes Kepler University Linz, Linz, Austria

10. Department of Neurology, Nordwest-Krankenhaus Sanderbusch, Friesland Kliniken GmbH, Sande, Germany

11. University Medical Center Göttingen, Göttingen, Germany

Abstract

Direct oral anticoagulants (DOACs) changed stroke prevention and decreased the risk of ischemic and hemorrhagic complications in patients on oral anticoagulation (OAC) therapy. The numbers of patients prescribed DOACs has increased rapidly. Availability of specific reversal agents opened new avenues in the prevention and management of DOAC complications. An ideal specific reversal agent for a DOAC in acute stroke is an agent which lacks safety concerns and immediately reverses DOAC anticoagulation activity, thereby enabling effective treatment. Reversal of anticoagulant activity is mandatory in patients with acute ischemic stroke (AIS) before performing therapeutic procedures such as intravenous thrombolysis (IVT) and neurosurgery in intracranial hemorrhage (ICH) in order to improve clinical outcomes. In this manuscript we pursue an interdisciplinary approach in discussing advantages and concerns of specific reversal agents in acute stroke DOAC-treated patients in everyday clinical practice.

Publisher

SAGE Publications

Link

https://journals.sagepub.com/doi/pdf/10.1177/10760296241279545

Reference52 articles.

1. Dabigatran versus Warfarin in Patients with Atrial Fibrillation

2. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation

3. Apixaban versus Warfarin in Patients with Atrial Fibrillation

4. Edoxaban versus Warfarin in Patients with Atrial Fibrillation

5. Real-World Setting Comparison of Nonvitamin-K Antagonist Oral Anticoagulants Versus Vitamin-K Antagonists for Stroke Prevention in Atrial Fibrillation