Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management.

Author: CheungKa-Shing, LeungWai K

Paper Details 
Original Abstract of the Article :
Novel oral anticoagulants (NOACs), which include direct thrombin inhibitor (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of v...See full text at original site
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引用元:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360636/

データ提供:米国国立医学図書館(NLM)

Navigating the Sands of Anticoagulant Treatment

Anticoagulants, like the mighty camels of the desert, are essential for maintaining a smooth flow. But just as a camel needs a steady hand to guide it, anticoagulant therapy requires careful management. This study focuses on the potential hazards of novel oral anticoagulants (NOACs) in relation to gastrointestinal bleeding (GIB). NOACs, which are becoming increasingly popular for preventing blood clots, can sometimes lead to unexpected detours in the form of bleeding, particularly in the gastrointestinal tract.

The study found that certain NOACs, including high doses of dabigatran, rivaroxaban, and edoxaban, may be associated with a higher risk of GIB. This is like a camel encountering a treacherous patch of shifting sand. Factors that increase the risk of GIB include older age, renal impairment, and the presence of Helicobacter pylori infection. It is crucial to avoid these treacherous pathways by carefully selecting patients, using lower doses of certain NOACs, and addressing modifiable risk factors.

Protecting the Vulnerable

Managing NOAC-related GIB requires a multi-pronged approach. Just as a caravan must be prepared for any eventuality, doctors can help prevent GIB by carefully choosing patients, using lower doses of certain NOACs, and correcting modifiable risk factors. In the event of GIB, immediate action is essential, with interventions ranging from withholding NOACs to administering specific reversal agents.

A Journey Through the Intricacies of Anticoagulation

This research highlights the complexities of anticoagulation therapy, emphasizing the importance of careful patient selection, risk assessment, and prompt management of bleeding complications. As doctors, we must navigate the delicate balance of preventing blood clots while minimizing the risk of bleeding, just as a wise camel navigates the unpredictable terrain of the desert.

Dr. Camel's Conclusion

This study serves as a reminder of the potential risks associated with NOACs and underscores the importance of careful patient selection, risk factor management, and prompt intervention in cases of GIB. Understanding the delicate dance between blood clotting and bleeding is paramount in ensuring safe and effective anticoagulation therapy.
Date :
  1. Date Completed 2017-09-14
  2. Date Revised 2018-11-13
Further Info :

Pubmed ID

28373761

DOI: Digital Object Identifier

PMC5360636

Related Literature

SNS
PICO Info
in preparation
Languages

English

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