Skip to main content
Erschienen in: Drugs 15/2012

01.11.2012 | Therapy In Practice

Management of Bleeding in Patients Receiving Conventional or New Anticoagulants

A Practical and Case-Based Approach

verfasst von: Marco P. Donadini, Walter Ageno, Dr James D. Douketis

Erschienen in: Drugs | Ausgabe 15/2012

Einloggen, um Zugang zu erhalten

Abstract

Anticoagulant drugs are highly effective for the prevention and treatment of venous and arterial thromboembolism. However, their use is also associated with an increased risk for bleeding, with an associated ~10% case-fatality rate. Appropriate strategies for the management and reversal of anticoagulant-associated bleeding are clinically important and, ideally, should be standardized. These include general resuscitation, and diagnosis and local treatment of the bleeding source, and one or more of the following interventions: transfusion of red cells; transfusion of clotting factor replacements; and administration of anticoagulant antidotes and other prohaemostatic agents. Reversal strategies for the ‘conventional’ anticoagulants are based largely on clinical evidence, whereas evidence to guide the management of bleeding associated with ‘new’ anticoagulants is emerging. This review provides an evidence-based, but practical, patient-focused approach for the management of bleeding associated with the old and new anticoagulants.
Literatur
1.
Zurück zum Zitat Warkentin AE, Donadini MP, Spencer FA, et al. Bleeding risk in randomized controlled trials comparing warfarin and aspirin: a systematic review and meta-analysis. J Thromb Haemost 2012; 10: 512–20PubMedCrossRef Warkentin AE, Donadini MP, Spencer FA, et al. Bleeding risk in randomized controlled trials comparing warfarin and aspirin: a systematic review and meta-analysis. J Thromb Haemost 2012; 10: 512–20PubMedCrossRef
2.
Zurück zum Zitat Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3: 692–4PubMedCrossRef Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3: 692–4PubMedCrossRef
3.
Zurück zum Zitat Schulman S, Angeras U, Bergqvist D, et al. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients. J Thromb Haemost 2010; 8: 202–4PubMedCrossRef Schulman S, Angeras U, Bergqvist D, et al. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients. J Thromb Haemost 2010; 8: 202–4PubMedCrossRef
4.
Zurück zum Zitat Ost D, Tepper J, Mihara H, et al. Duration of anticoagulation following venous thromboembolism: a meta-analysis. JAMA 2005; 294: 76–715 Ost D, Tepper J, Mihara H, et al. Duration of anticoagulation following venous thromboembolism: a meta-analysis. JAMA 2005; 294: 76–715
5.
Zurück zum Zitat Palareti G, Leali N, Coccheri S, et al. Bleeding complication of anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Lancet 1996; 348: 423–8PubMedCrossRef Palareti G, Leali N, Coccheri S, et al. Bleeding complication of anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Lancet 1996; 348: 423–8PubMedCrossRef
6.
Zurück zum Zitat Sørensen R, Hansen ML, Abildstrom SZ, et al. Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data. Lancet 2009; 374: 1947–8CrossRef Sørensen R, Hansen ML, Abildstrom SZ, et al. Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data. Lancet 2009; 374: 1947–8CrossRef
7.
Zurück zum Zitat Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e419S–94SPubMedCrossRef Kearon C, Akl EA, Comerota AJ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e419S–94SPubMedCrossRef
8.
Zurück zum Zitat Schulman S, Beyth RJ, Kearon C, et al. Hemorrhagic complications of anticoagulant and thrombolytic treatment: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008; 133 (6 Suppl.): 257S–98SPubMedCrossRef Schulman S, Beyth RJ, Kearon C, et al. Hemorrhagic complications of anticoagulant and thrombolytic treatment: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008; 133 (6 Suppl.): 257S–98SPubMedCrossRef
9.
Zurück zum Zitat Carrier M, Le Gal G, Wells PS, et al. Systematic review: case-fatality rates of recurrent venous thromboembolism and major bleeding events among patients treated for venous thromboembolism. Ann Intern Med 2010; 152: 578–89PubMedCrossRef Carrier M, Le Gal G, Wells PS, et al. Systematic review: case-fatality rates of recurrent venous thromboembolism and major bleeding events among patients treated for venous thromboembolism. Ann Intern Med 2010; 152: 578–89PubMedCrossRef
10.
Zurück zum Zitat Linkins LA, Choi PT, Douketis JD. Clinical impact of bleeding in patients taking oral anticoagulant therapy for venous thromboembolism: a meta-analysis. Ann Intern Med 2003; 139: 893–900PubMedCrossRef Linkins LA, Choi PT, Douketis JD. Clinical impact of bleeding in patients taking oral anticoagulant therapy for venous thromboembolism: a meta-analysis. Ann Intern Med 2003; 139: 893–900PubMedCrossRef
11.
12.
Zurück zum Zitat Ageno W, Gallus AS, Wittkowsky A, et al. Oral anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e44S–88SPubMedCrossRef Ageno W, Gallus AS, Wittkowsky A, et al. Oral anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e44S–88SPubMedCrossRef
13.
Zurück zum Zitat Holbrook A, Schulman S, Witt DM, et al. Evidence-based management of anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e152S–84SPubMedCrossRef Holbrook A, Schulman S, Witt DM, et al. Evidence-based management of anticoagulant therapy: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e152S–84SPubMedCrossRef
14.
Zurück zum Zitat Fiore LD, Scola MA, Cantillon CE, et al. Anaphylactoid reactions to vitamin K. J Thromb Thrombolysis 2001; 11: 175–83PubMedCrossRef Fiore LD, Scola MA, Cantillon CE, et al. Anaphylactoid reactions to vitamin K. J Thromb Thrombolysis 2001; 11: 175–83PubMedCrossRef
15.
Zurück zum Zitat Riegert-Johnson DL, Volcheck GW. The incidence of anaphylaxis following intravenous phytonadione (vitamin K1): a 5-year retrospective review. Ann Allergy Asthma Immunol 2002; 89: 400–6PubMedCrossRef Riegert-Johnson DL, Volcheck GW. The incidence of anaphylaxis following intravenous phytonadione (vitamin K1): a 5-year retrospective review. Ann Allergy Asthma Immunol 2002; 89: 400–6PubMedCrossRef
16.
Zurück zum Zitat White RH, McKittrick T, Hutchinson R, et al. Temporary discontinuation of warfarin therapy: changes in international normalized ratio. Ann Intern Med 1995; 122: 40–2PubMedCrossRef White RH, McKittrick T, Hutchinson R, et al. Temporary discontinuation of warfarin therapy: changes in international normalized ratio. Ann Intern Med 1995; 122: 40–2PubMedCrossRef
17.
Zurück zum Zitat Contreras M, Ala FA, Greaves M, et al. Guidelines for the use of fresh frozen plasma. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force. Transfus Med 1992; 2: 57–63PubMedCrossRef Contreras M, Ala FA, Greaves M, et al. Guidelines for the use of fresh frozen plasma. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force. Transfus Med 1992; 2: 57–63PubMedCrossRef
18.
Zurück zum Zitat O’Shaughnessy DF, Atterbury C, Bolton Maggs P, et al. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 2004; 126: 11–28PubMedCrossRef O’Shaughnessy DF, Atterbury C, Bolton Maggs P, et al. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 2004; 126: 11–28PubMedCrossRef
19.
Zurück zum Zitat Khan H, Belsher J, Yilmaz M, et al. Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest 2007; 131: 1308–14PubMedCrossRef Khan H, Belsher J, Yilmaz M, et al. Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest 2007; 131: 1308–14PubMedCrossRef
20.
Zurück zum Zitat Lubetsky A, Hoffman R, Zimlichman R, et al. Efficacy and safety of a Prothrombin Complex Concentrate (Octaplex) for rapid reversal of oral anticoagulation. Thromb Res 2004; 113: 371–8PubMedCrossRef Lubetsky A, Hoffman R, Zimlichman R, et al. Efficacy and safety of a Prothrombin Complex Concentrate (Octaplex) for rapid reversal of oral anticoagulation. Thromb Res 2004; 113: 371–8PubMedCrossRef
21.
Zurück zum Zitat Dentali F, Marchesi C, Giorgi Piefranceschi M, et al. Safety of prothrombin complex concentrates for rapid anticoagulation reversal of vitamin K antagonists. Thromb Haemost 2011; 106:429–38PubMedCrossRef Dentali F, Marchesi C, Giorgi Piefranceschi M, et al. Safety of prothrombin complex concentrates for rapid anticoagulation reversal of vitamin K antagonists. Thromb Haemost 2011; 106:429–38PubMedCrossRef
22.
Zurück zum Zitat Dentali F, Ageno W, Crowther M. Treatment of coumarin-associated coagulopathy: a systematic review and proposed treatment algorithms. J Thromb Haemost 2006; 4: 1853–63PubMedCrossRef Dentali F, Ageno W, Crowther M. Treatment of coumarin-associated coagulopathy: a systematic review and proposed treatment algorithms. J Thromb Haemost 2006; 4: 1853–63PubMedCrossRef
23.
Zurück zum Zitat Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139–51PubMedCrossRef Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139–51PubMedCrossRef
24.
Zurück zum Zitat Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883–91PubMedCrossRef Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883–91PubMedCrossRef
25.
Zurück zum Zitat EINSTEIN Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010; 363: 2499–510CrossRef EINSTEIN Investigators. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010; 363: 2499–510CrossRef
26.
Zurück zum Zitat EINSTEIN-PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012; 366: 1287–97CrossRef EINSTEIN-PE Investigators. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012; 366: 1287–97CrossRef
27.
Zurück zum Zitat Douketis JD, Arneklev K, Goldhaber SZ, et al. Comparison of bleeding in patients with nonvalvular atrial fibrillation treated with ximelagatran or warfarin: assessment of incidence, case-fatality rate, time course and sites of bleeding, and risk factors for bleeding. Arch Intern Med 2006; 166: 853–9PubMedCrossRef Douketis JD, Arneklev K, Goldhaber SZ, et al. Comparison of bleeding in patients with nonvalvular atrial fibrillation treated with ximelagatran or warfarin: assessment of incidence, case-fatality rate, time course and sites of bleeding, and risk factors for bleeding. Arch Intern Med 2006; 166: 853–9PubMedCrossRef
28.
Zurück zum Zitat Ufer M. Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development. Thromb Haemost 2010; 103: 572–85PubMedCrossRef Ufer M. Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development. Thromb Haemost 2010; 103: 572–85PubMedCrossRef
29.
Zurück zum Zitat Weinz C, Schwarz T, Kubitza D, et al. Metabolism and excretion of rivaroxaban, an oral, direct factor Xa inhibitor, in rats, dogs, and humans. Drug Metab Dispos 2009; 37: 1056–64PubMedCrossRef Weinz C, Schwarz T, Kubitza D, et al. Metabolism and excretion of rivaroxaban, an oral, direct factor Xa inhibitor, in rats, dogs, and humans. Drug Metab Dispos 2009; 37: 1056–64PubMedCrossRef
30.
Zurück zum Zitat van Ryn J, Stangier J, Haertter S, et al. Dabigatran etexilate: a novel, reversible, oral direct thrombin inhibitor. Interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost 2010; 103: 1116–27PubMedCrossRef van Ryn J, Stangier J, Haertter S, et al. Dabigatran etexilate: a novel, reversible, oral direct thrombin inhibitor. Interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost 2010; 103: 1116–27PubMedCrossRef
31.
Zurück zum Zitat Kubitza D, Becka M, Mueck W, et al. Effects of renal impairment on the pharmacokinetics, pharmacodynamics and safety of rivaroxaban, an oral, direct factor Xa inhibitor. Br J Clin Pharmacol 2010; 70: 703–12PubMedCrossRef Kubitza D, Becka M, Mueck W, et al. Effects of renal impairment on the pharmacokinetics, pharmacodynamics and safety of rivaroxaban, an oral, direct factor Xa inhibitor. Br J Clin Pharmacol 2010; 70: 703–12PubMedCrossRef
32.
Zurück zum Zitat van Ryn J, Sieger P, Kink-Eiband M, et al. Adsorption of dabigatran etexilate in water or dabigatran in pooled human plasma by activated charcoal in vitro [abstract]. 51st ASH Annual Meeting and Exposition; 2009 Dec 7–8; New Orleans (LA) van Ryn J, Sieger P, Kink-Eiband M, et al. Adsorption of dabigatran etexilate in water or dabigatran in pooled human plasma by activated charcoal in vitro [abstract]. 51st ASH Annual Meeting and Exposition; 2009 Dec 7–8; New Orleans (LA)
33.
Zurück zum Zitat Zhou W, Schwarting S, Illanes S, et al. Hemostatic therapy in experimental intracerebral hemorrhage associated with the direct thrombin inhibitor dabigatran. Stroke 2011; 42: 3594–9PubMedCrossRef Zhou W, Schwarting S, Illanes S, et al. Hemostatic therapy in experimental intracerebral hemorrhage associated with the direct thrombin inhibitor dabigatran. Stroke 2011; 42: 3594–9PubMedCrossRef
34.
Zurück zum Zitat Eerenberg ES, Kamphuisen PW, Sijpkens MK, et al. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation 2011; 124: 1573–9PubMedCrossRef Eerenberg ES, Kamphuisen PW, Sijpkens MK, et al. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation 2011; 124: 1573–9PubMedCrossRef
35.
Zurück zum Zitat Marlu R, Hodaj E, Paris A, et al. Effect of non-specific reversal agents on anticoagulant activity of dabigatran and rivaroxaban: a randomised crossover ex vivo study in healthy volunteers. Thromb Haemost 2012 Jul 25; 108 (2): 217–24PubMedCrossRef Marlu R, Hodaj E, Paris A, et al. Effect of non-specific reversal agents on anticoagulant activity of dabigatran and rivaroxaban: a randomised crossover ex vivo study in healthy volunteers. Thromb Haemost 2012 Jul 25; 108 (2): 217–24PubMedCrossRef
36.
Zurück zum Zitat van Ryn J, Kink-Eiband M, Clemens A. The successful reversal of dabigatran-induced bleeding by coagulation factor concentrates in a rat tail bleeding model do not correlate with ex vivo markers of anticogulation [abstract]. 53rd ASH Annual Meeting and Exposition; 2011 Dec 10–13; San Diego (CA) van Ryn J, Kink-Eiband M, Clemens A. The successful reversal of dabigatran-induced bleeding by coagulation factor concentrates in a rat tail bleeding model do not correlate with ex vivo markers of anticogulation [abstract]. 53rd ASH Annual Meeting and Exposition; 2011 Dec 10–13; San Diego (CA)
37.
Zurück zum Zitat Tinel H, Huetter J, Perzborn E. Recombinant factor VIIA partially reverses the anticoagulant effect of high-dose rivaroxaban a novel, oral, direct factor Xa inhibitor in rats [abstract no. P-W-652]. J Thromb Haemost 2007; 5 Tinel H, Huetter J, Perzborn E. Recombinant factor VIIA partially reverses the anticoagulant effect of high-dose rivaroxaban a novel, oral, direct factor Xa inhibitor in rats [abstract no. P-W-652]. J Thromb Haemost 2007; 5
38.
Zurück zum Zitat Gruber A, Marzec UM, Holcomb JB. Potential of activated prothrombin complex concentrate and activated factor VII to reverse the anticoagulant effects of rivaroxaban in primates [abstract]. 50th ASH Annual Meeting and Exposition; 2008 Dec 6–9; San Francisco (CA) Gruber A, Marzec UM, Holcomb JB. Potential of activated prothrombin complex concentrate and activated factor VII to reverse the anticoagulant effects of rivaroxaban in primates [abstract]. 50th ASH Annual Meeting and Exposition; 2008 Dec 6–9; San Francisco (CA)
39.
Zurück zum Zitat Stangier J, Rathgen K, Stahle H, et al. Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. Clin Pharmacokinet 2010; 49: 259–68PubMedCrossRef Stangier J, Rathgen K, Stahle H, et al. Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. Clin Pharmacokinet 2010; 49: 259–68PubMedCrossRef
40.
Zurück zum Zitat Kaatz S, Kouides PA, Garcia DA, et al. Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors. Am J Hematol 2012; 87 Suppl. 1: S141–5PubMedCrossRef Kaatz S, Kouides PA, Garcia DA, et al. Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors. Am J Hematol 2012; 87 Suppl. 1: S141–5PubMedCrossRef
41.
Zurück zum Zitat Büller HR, Davidson BL, Decousus H, et al. Fondaparinux or enoxaparin for the initial treatment of symptomatic deep venous thrombosis: a randomized trial. Ann Intern Med 2004; 140: 867–73PubMedCrossRef Büller HR, Davidson BL, Decousus H, et al. Fondaparinux or enoxaparin for the initial treatment of symptomatic deep venous thrombosis: a randomized trial. Ann Intern Med 2004; 140: 867–73PubMedCrossRef
42.
Zurück zum Zitat Büller HR, Davidson BL, Decousus H, et al. Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism. N Engl J Med 2003; 349: 1695–702PubMedCrossRef Büller HR, Davidson BL, Decousus H, et al. Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism. N Engl J Med 2003; 349: 1695–702PubMedCrossRef
43.
Zurück zum Zitat Decousus H, Prandoni P, Mismetti P, et al. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 2010; 363: 1222–32PubMedCrossRef Decousus H, Prandoni P, Mismetti P, et al. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 2010; 363: 1222–32PubMedCrossRef
44.
Zurück zum Zitat Garcia DA, Baglin TP, Weitz JI, et al. Parenteral anticoagulants: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e24S–43SPubMedCrossRef Garcia DA, Baglin TP, Weitz JI, et al. Parenteral anticoagulants: antithrombotic therapy and prevention of thrombosis, 9th edition: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141 (2 Suppl.): e24S–43SPubMedCrossRef
45.
Zurück zum Zitat Bara L, Billaud E, Gramond G, et al. Comparative pharmacokinetics of a low molecular weight heparin (PK 10 169) and unfractionated heparin after intravenous and subcutaneous administration. Thromb Res 1985; 39: 631–6PubMedCrossRef Bara L, Billaud E, Gramond G, et al. Comparative pharmacokinetics of a low molecular weight heparin (PK 10 169) and unfractionated heparin after intravenous and subcutaneous administration. Thromb Res 1985; 39: 631–6PubMedCrossRef
46.
Zurück zum Zitat Levi M, Eerenberg E, Kamphuisen PW. Bleeding risk and reversal strategies for old and new anticoagulants and antiplatelet agents. J Thromb Haemost 2011; 9 (9): 1705–12PubMedCrossRef Levi M, Eerenberg E, Kamphuisen PW. Bleeding risk and reversal strategies for old and new anticoagulants and antiplatelet agents. J Thromb Haemost 2011; 9 (9): 1705–12PubMedCrossRef
47.
Zurück zum Zitat Caplan SN, Berkman EM. Protamine sulfate and fish allergy [letter]. N Engl J Med 1976; 295 (3): 172PubMed Caplan SN, Berkman EM. Protamine sulfate and fish allergy [letter]. N Engl J Med 1976; 295 (3): 172PubMed
48.
Zurück zum Zitat Levi M, Eerenberg E, Lowenberg E, et al. Bleeding in patients using new anticoagulants or antiplatelet agents: risk factors and management. Neth J Med 2010; 68: 68–76PubMed Levi M, Eerenberg E, Lowenberg E, et al. Bleeding in patients using new anticoagulants or antiplatelet agents: risk factors and management. Neth J Med 2010; 68: 68–76PubMed
49.
Zurück zum Zitat Ng HJ, Koh LP, Lee LH. Successful control of postsurgical bleeding by recombinant factor VIIa in a renal failure patient given low molecular weight heparin and aspirin. Ann Hematol 2003; 82: 257–8PubMed Ng HJ, Koh LP, Lee LH. Successful control of postsurgical bleeding by recombinant factor VIIa in a renal failure patient given low molecular weight heparin and aspirin. Ann Hematol 2003; 82: 257–8PubMed
50.
Zurück zum Zitat Elmer J, Wittels KA. Emergency reversal of pentasaccharide anticoagulants: a systematic review of the literature. Transfus Med 2012; 22: 108–15PubMedCrossRef Elmer J, Wittels KA. Emergency reversal of pentasaccharide anticoagulants: a systematic review of the literature. Transfus Med 2012; 22: 108–15PubMedCrossRef
51.
Zurück zum Zitat Desmurs-Clavel H, Huchon C, Chatard B, et al. Reversal of the inhibitory effect of fondaparinux on thrombin generation by rFVIIa, aPCC and PCC. Thromb Res 2009; 123: 796–8PubMedCrossRef Desmurs-Clavel H, Huchon C, Chatard B, et al. Reversal of the inhibitory effect of fondaparinux on thrombin generation by rFVIIa, aPCC and PCC. Thromb Res 2009; 123: 796–8PubMedCrossRef
52.
Zurück zum Zitat Bijsterveld NR, Vink R, van Aken BE, et al. Recombinant factor VIIa reverses the anticoagulant effect of the long-acting pentasaccharide idraparinux in healthy volunteers. Br J Haematol 2004; 124: 653–8PubMedCrossRef Bijsterveld NR, Vink R, van Aken BE, et al. Recombinant factor VIIa reverses the anticoagulant effect of the long-acting pentasaccharide idraparinux in healthy volunteers. Br J Haematol 2004; 124: 653–8PubMedCrossRef
53.
Zurück zum Zitat Bijsterveld NR, Moons AH, Boekholdt SM, et al. Ability of recombinant factor VIIa to reverse the anticoagulant effect of the pentasaccharide fondaparinux in healthy volunteers. Circulation 2002; 106: 2550–4PubMedCrossRef Bijsterveld NR, Moons AH, Boekholdt SM, et al. Ability of recombinant factor VIIa to reverse the anticoagulant effect of the pentasaccharide fondaparinux in healthy volunteers. Circulation 2002; 106: 2550–4PubMedCrossRef
54.
Zurück zum Zitat Bianchini EP, Fazavana J, Picard V, et al. Development of a recombinant antithrombin variant as a potent antidote to fondaparinux and other heparin derivatives. Blood 2011; 117: 2054–60PubMedCrossRef Bianchini EP, Fazavana J, Picard V, et al. Development of a recombinant antithrombin variant as a potent antidote to fondaparinux and other heparin derivatives. Blood 2011; 117: 2054–60PubMedCrossRef
55.
Zurück zum Zitat Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981–92PubMedCrossRef Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365: 981–92PubMedCrossRef
56.
Zurück zum Zitat Connolly SJ, Eikelboom J, Joyner C, et al. Apixaban in patients with atrial fibrillation. N Engl J Med 2011; 364: 806–17PubMedCrossRef Connolly SJ, Eikelboom J, Joyner C, et al. Apixaban in patients with atrial fibrillation. N Engl J Med 2011; 364: 806–17PubMedCrossRef
57.
Zurück zum Zitat Equinox Investigators. Efficacy and safety of once weekly subcutaneous idrabiotaparinux in the treatment of patients with symptomatic deep venous thrombosis. J Thromb Haemost 2011; 9: 92–9CrossRef Equinox Investigators. Efficacy and safety of once weekly subcutaneous idrabiotaparinux in the treatment of patients with symptomatic deep venous thrombosis. J Thromb Haemost 2011; 9: 92–9CrossRef
58.
Zurück zum Zitat Paty J, Trellu M, Destors JM, et al. Reversibility of the anti-Xa activity of idrabiotaparinux (biotinylated idraparinux) by intravenous avidin infusion. J Thromb Haemost 2010; 8: 722–9PubMedCrossRef Paty J, Trellu M, Destors JM, et al. Reversibility of the anti-Xa activity of idrabiotaparinux (biotinylated idraparinux) by intravenous avidin infusion. J Thromb Haemost 2010; 8: 722–9PubMedCrossRef
59.
Zurück zum Zitat Büller HR, Gallus AS, Pillion G, et al. Enoxaparin followed by once-weekly idrabiotaparinux versus enoxaparin plus warfarin for patients with acute symptomatic pulmonary embolism: a randomised, double-blind, double-dummy, non-inferiority trial. Lancet 2012; 379: 123–9PubMedCrossRef Büller HR, Gallus AS, Pillion G, et al. Enoxaparin followed by once-weekly idrabiotaparinux versus enoxaparin plus warfarin for patients with acute symptomatic pulmonary embolism: a randomised, double-blind, double-dummy, non-inferiority trial. Lancet 2012; 379: 123–9PubMedCrossRef
60.
Zurück zum Zitat Bianchini EP, Fazavana J, Picard V, et al. Development of a recombinant antithrombin variant as a potent antidote to fondaparinux and other heparin derivatives. Blood 2011 Feb 10; 117 (6): 2054–60PubMedCrossRef Bianchini EP, Fazavana J, Picard V, et al. Development of a recombinant antithrombin variant as a potent antidote to fondaparinux and other heparin derivatives. Blood 2011 Feb 10; 117 (6): 2054–60PubMedCrossRef
61.
Zurück zum Zitat Lu G, Deguzman FR, Karbarz MJ, et al. Reversal of rivaroxaban mediated anticoagulation in animal models by a recombinant antidote protein (r-Antidote, PRT064445). Eur Heart J 2011; 32 (Abstract Suppl.):640–1 Lu G, Deguzman FR, Karbarz MJ, et al. Reversal of rivaroxaban mediated anticoagulation in animal models by a recombinant antidote protein (r-Antidote, PRT064445). Eur Heart J 2011; 32 (Abstract Suppl.):640–1
Metadaten
Titel
Management of Bleeding in Patients Receiving Conventional or New Anticoagulants
A Practical and Case-Based Approach
verfasst von
Marco P. Donadini
Walter Ageno
Dr James D. Douketis
Publikationsdatum
01.11.2012
Verlag
Springer International Publishing
Erschienen in
Drugs / Ausgabe 15/2012
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI
https://doi.org/10.2165/11641160-000000000-00000

Weitere Artikel der Ausgabe 15/2012

Drugs 15/2012 Zur Ausgabe

Adis Drug Profile

Carfilzomib

Adis Drug Profile

Aclidinium

Adis Drug Profile

Ferumoxytol