The results of multiple randomized controlled trials have established that the direct
oral anticoagulants (DOACs) are at least as effective as warfarin for the prevention
of stroke or systemic embolism in patients with atrial fibrillation and for the prevention
of recurrence in patients with venous thromboembolism, while producing similar or
lower rates of major bleeding.
1
,
2
Nonetheless, DOACs are still associated with serious bleeding. The lack of a specific
antidote has raised concerns about the inability to promptly reverse their anticoagulant
effect in patients with major bleeding and in those who require emergency surgery.
Clinicians are worried that the lack of a specific antidote will lead to adverse outcomes
when these drugs are used outside of the controlled environment of a randomized trial.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 27, 2014
Accepted:
January 23,
2014
Received:
December 16,
2013
Footnotes
See page 383 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
