Reversal of oral anticoagulation in patients with acute intracerebral hemorrhage

Beitrag in einer Fachzeitschrift
(Review-Artikel)


Details zur Publikation

Autorinnen und Autoren: Kuramatsu JB, Sembill JA, Huttner H
Zeitschrift: Critical Care
Jahr der Veröffentlichung: 2019
Band: 23
Heftnummer: 1
ISSN: 1364-8535
eISSN: 1466-609X


Abstract

In light of an aging population with increased cardiovascular comorbidity, the use of oral anticoagulation (OAC) is steadily expanding. A variety of pharmacological alternatives to vitamin K antagonists (VKA) have emerged over recent years (direct oral anticoagulants, DOAC, i.e., dabigatran, rivaroxaban, apixaban, and edoxaban) which show a reduced risk for the occurrence of intracerebral hemorrhage (ICH). Yet, in the event of ICH under OAC (OAC-ICH), hematoma characteristics are similarly severe and clinical outcomes likewise substantially limited in both patients with VKA- and DOAC-ICH, which is why optimal acute hemostatic treatment in all OAC-ICH needs to be guaranteed. Currently, International Guidelines for the hemostatic management of patients with OAC-ICH are updated as several relevant large-sized observational studies and recent trials have established treatment approaches for both VKA- and DOAC-ICH. While the management of VKA-ICH is mainly based on the immediate reversal of elevated levels of international normalized ratio using prothrombin complex concentrates, hemostatic management of DOAC-associated ICH is challenging requiring specific antidotes, notably idarucizumab and andexanet alfa. This review will provide an overview of the latest studies and trials on hemostatic reversal agents and timing and summarizes the effects on hemorrhage progression and clinical outcomes in patients with OAC-ICH.


FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Huttner, Hagen Prof. Dr.
Medizinische Fakultät
Sembill, Jochen
Medizinische Fakultät


Zitierweisen

APA:
Kuramatsu, J.B., Sembill, J.A., & Huttner, H. (2019). Reversal of oral anticoagulation in patients with acute intracerebral hemorrhage. Critical Care, 23(1). https://dx.doi.org/10.1186/s13054-019-2492-8

MLA:
Kuramatsu, Joji B., Jochen Alexander Sembill, and Hagen Huttner. "Reversal of oral anticoagulation in patients with acute intracerebral hemorrhage." Critical Care 23.1 (2019).

BibTeX: 

Zuletzt aktualisiert 2019-21-06 um 09:38