Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke.

IF 2.3 4区医学 Q2 HEMATOLOGY

Clinical and Applied Thrombosis/Hemostasis Pub Date : 2024-01-01 DOI:10.1177/10760296241279545

Senta Frol, Janja Pretnar Oblak, Mišo Šabovič, Wim H van Zwam, George Ntaios, Karl Olof Lövblad, Andreas Gruber, Pawel Kermer

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引用次数: 0

Abstract

Direct oral anticoagulants (DOACs) changed stroke prevention and decreased the risk of ischemic and hemorrhagic complications in patients on oral anticoagulation (OAC) therapy. The numbers of patients prescribed DOACs has increased rapidly. Availability of specific reversal agents opened new avenues in the prevention and management of DOAC complications. An ideal specific reversal agent for a DOAC in acute stroke is an agent which lacks safety concerns and immediately reverses DOAC anticoagulation activity, thereby enabling effective treatment. Reversal of anticoagulant activity is mandatory in patients with acute ischemic stroke (AIS) before performing therapeutic procedures such as intravenous thrombolysis (IVT) and neurosurgery in intracranial hemorrhage (ICH) in order to improve clinical outcomes. In this manuscript we pursue an interdisciplinary approach in discussing advantages and concerns of specific reversal agents in acute stroke DOAC-treated patients in everyday clinical practice.

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急性脑卒中直接口服抗凝剂的特异性逆转剂。

直接口服抗凝药（DOACs）改变了中风的预防方法，降低了口服抗凝药（OAC）患者发生缺血性和出血性并发症的风险。接受 DOACs 治疗的患者人数迅速增加。特异性逆转剂的出现为预防和治疗 DOAC 并发症开辟了新途径。急性卒中 DOAC 的理想特异性逆转剂是一种缺乏安全顾虑且能立即逆转 DOAC 抗凝活性的药物，从而实现有效治疗。在对急性缺血性卒中（AIS）患者实施静脉溶栓（IVT）和颅内出血（ICH）神经外科手术等治疗程序之前，必须逆转抗凝活性，以改善临床预后。在本手稿中，我们采用跨学科方法讨论了在日常临床实践中急性卒中 DOAC 治疗患者使用特定逆转剂的优势和注意事项。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Applied Thrombosis/Hemostasis 医学-外周血管病

CiteScore

4.40

自引率

3.40%

发文量

150

审稿时长

2 months

期刊介绍： CATH is a peer-reviewed bi-monthly journal that addresses the practical clinical and laboratory issues involved in managing bleeding and clotting disorders, especially those related to thrombosis, hemostasis, and vascular disorders. CATH covers clinical trials, studies on etiology, pathophysiology, diagnosis and treatment of thrombohemorrhagic disorders.