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Evaluation of bleeding in patients receiving direct oral anticoagulants

Authors Hellenbart EL, Faulkenberg KD, Finks SW

Received 22 April 2017

Accepted for publication 19 June 2017

Published 23 August 2017 Volume 2017:13 Pages 325—342


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Editor who approved publication: Dr Daniel Duprez

Video abstract presented by Erika L Hellenbart.

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Erika L Hellenbart,1 Kathleen D Faulkenberg,2 Shannon W Finks3

1University of Illinois at Chicago College of Pharmacy, Chicago, IL, 2Cleveland Clinic, Cleveland, OH, 3University of Tennessee College of Pharmacy, Memphis, TN, USA

Abstract: Direct oral anticoagulants (DOACs) are recognized by evidence-based treatment guidelines as the first-line option for the treatment of venous thromboembolism and prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. As use of these anticoagulants has become favored over the past several years, reported bleeding-related adverse drug events with these agents has increased. In randomized clinical trials, all DOACs have a reduced risk for intracranial hemorrhage, while major and other bleeding results have varied among the agents compared to vitamin K antagonists. We have reviewed the bleeding incidence and severity from randomized and real-world data in patients receiving DOACs in an effort to provide the clinician with a critical review of bleeding and offer practical considerations for avoiding adverse events with these anticoagulants.

Keywords: bleeding, direct oral anticoagulants, dabigatran, rivaroxaban, apixaban, edoxaban, post-market bleeding

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