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Practice

Direct oral anticoagulants and the bleeding patient

Brendan Wood, Michelle Sholzberg and Alun Ackery
CMAJ February 16, 2016 188 (3) 215; DOI: https://doi.org/10.1503/cmaj.150604
Brendan Wood
Division of Emergency Medicine (Wood, Ackery) and Division of Hematology (Sholzberg), Department of Medicine, University of Toronto; Division of Hematopathology (Sholzberg), Coagulation Laboratory and Pathobiology, Department of Laboratory Medicine, University of Toronto; and St. Michael’s Hospital (Ackery, Sholzberg), Toronto, Ont.
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Michelle Sholzberg
Division of Emergency Medicine (Wood, Ackery) and Division of Hematology (Sholzberg), Department of Medicine, University of Toronto; Division of Hematopathology (Sholzberg), Coagulation Laboratory and Pathobiology, Department of Laboratory Medicine, University of Toronto; and St. Michael’s Hospital (Ackery, Sholzberg), Toronto, Ont.
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Alun Ackery
Division of Emergency Medicine (Wood, Ackery) and Division of Hematology (Sholzberg), Department of Medicine, University of Toronto; Division of Hematopathology (Sholzberg), Coagulation Laboratory and Pathobiology, Department of Laboratory Medicine, University of Toronto; and St. Michael’s Hospital (Ackery, Sholzberg), Toronto, Ont.
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  • For correspondence: alun.ackery@mail.utoronto.ca
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Canadian Medical Association Journal: 188 (3)
CMAJ
Vol. 188, Issue 3
16 Feb 2016
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Direct oral anticoagulants and the bleeding patient
Brendan Wood, Michelle Sholzberg, Alun Ackery
CMAJ Feb 2016, 188 (3) 215; DOI: 10.1503/cmaj.150604

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Direct oral anticoagulants and the bleeding patient
Brendan Wood, Michelle Sholzberg, Alun Ackery
CMAJ Feb 2016, 188 (3) 215; DOI: 10.1503/cmaj.150604
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    • Direct oral anticoagulant agents are now routinely used for the prevention of stroke in nonvalvular atrial fibrillation
    • Risk of bleeding with direct oral anticoagulants is lower than with vitamin K antagonists, but varies by site
    • Direct oral anticoagulants are characterized by rapid onset of action and short half-lives2
    • Direct oral anticoagulants variably affect standard clot-based assays
    • Idarucizumab has recently been approved by the US Food and Drug Administration to reverse the activity of dabigatran
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