![]() ![]() Warfarin, the first oral anticoagulant, was approved for use by the FDA in 1954 and for over half a century remained the most widely used oral anticoagulant in practice ( 2). A major overlying goal of management of each condition is the reduction of thromboembolic (TE) events. Worldwide, there are approximately 3 million patients suffering with atrial fibrillation and 75,000 patients who are diagnosed with venous thromboembolism (VTE) annually ( 1). Keywords: Atrial fibrillation direct oral anticoagulants (DOAC) oral anticoagulant reversal venous thromboembolism (VTE) andexanet alfa idarucizumab factor Xa inhibitors factor Xa inhibitors reversal direct thrombin inhibitors direct thrombin inhibitor reversal Until future studies are available, current literature must be critically evaluated to aid in the clinical decision-making process of how to treat patients with life-threatening DOAC-related bleeding. Data exists describing both prothrombin complex concentrates (PCC) and andexanet alfa for DOAC reversal, however, without head-to-head comparison. Due to the manufacturing practices required to yield these reversal therapies, they are available at high cost to hospital systems and as a result, have been met with resistance. Since then, idarucizumab has been approved for dabigatran reversal and recently, andexanet alfa was granted approval for the reversal of apixaban or rivaroxaban in patients with life-threatening or uncontrolled bleeding events. Until 2015, warfarin maintained an advantage as the only oral anticoagulant with a specific reversal agent. With increased DOAC use, the number of major bleeding events requiring medical intervention will continue to rise. ![]() Policy of Dealing with Allegations of Research MisconductĪbstract: Utilization of direct oral anticoagulants (DOAC) have steadily increased since their approval and are now recommended over warfarin for both stroke prevention in nonvalvular atrial fibrillation and treatment of venous thromboembolism (VTE).Policy of Screening for Plagiarism Process. ![]()
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