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International Journal of Emergency Medicine
Published in: International Journal of Emergency Medicine 1/2018

Open Access 01-12-2018 | Review

The impact of prothrombin complex concentrates when treating DOAC-associated bleeding: a review

Authors: Maureane Hoffman, Joshua N. Goldstein, Jerrold H. Levy

Published in: International Journal of Emergency Medicine | Issue 1/2018

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Abstract

Background

Bleeding complications are a risk associated with all anticoagulants. Currently, the treatment options for the management of direct oral anticoagulant (DOAC)-associated bleeding are limited. Prothrombin complex concentrates (PCCs) have been proposed as a potential therapeutic option, and evidence regarding their use is increasing.

Review

Many studies supporting PCC have used preclinical models and healthy volunteers; however, more recently, observational studies have further improved insight into current DOAC reversal strategies. Multiple clinical practice guidelines now specifically suggest use of PCCs for this indication. Specific reversal agents for Factor Xa inhibitors may become available in the near future, but data on their efficacy are still emerging.

Conclusions

Ultimately, a multimodal approach may be the optimal strategy to restore haemostasis in patients presenting with DOAC-associated coagulopathy.
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Metadata
Title
The impact of prothrombin complex concentrates when treating DOAC-associated bleeding: a review
Authors
Maureane Hoffman
Joshua N. Goldstein
Jerrold H. Levy
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 1/2018
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1186/s12245-018-0215-6

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