TY  - JOUR
A1  - Steiner, Thorsten
A1  - Köhrmann, Martin
A1  - Schellinger, Peter Dieter
A1  - Tsivgoulis, Georgios
T1  - Non-vitamin K oral anticoagulants associated bleeding and its antidotes
T2  - Journal of stroke
N2  - Oral anticoagulant-associated intracerebral hemorrhage (OAC-ICH) accounts for nearly 20% of all ICH. The number of patients with an indication for oral anticoagulant therapy (OAT) increases with increasing age. OAT became less complicate with the introduction of non-vitamin K oral anticoagulants (NOAC) OAT because of easier handling, favorable risk-benefit profile, reduced rates of ICH compared to vitamin K antagonists and no need for routine coagulation testing. Consequently, despite a better safety profile of NOAC the number of patients with OAC-ICH will increase. The mortality and complication rates of OAC-ICH are high and therefore they are the most feared complication of OAT. Immediate normalization of coagulation is the main goal and therefore knowledge of pharmacodynamics and coagulation status is essential. Laboratory measurements of anticoagulant activity in NOAC patients is challenging as specific tests are not widely available. More accessible tests such as the prothrombin time and activated partial thromboplastin time have important limitations. In dabigatran-associated ICH 5 g Idarucizumab should be administered. In rivaroxaban and apixaban-associated ICHs administration of andexanet alpha should be considered. Prothrombin complex concentrate may be considered if andexanet alpha is not available or in case of an ICH associated with edoxaban.
KW  - Apixaban
KW  - Dabigatran
KW  - Edoxaban
KW  - Rivaroxaban
KW  - Idarucizumab
KW  - Andexanet alpha
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/47706
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-477066
SN  - 2287-6405
SN  - 2287-6391
N1  - This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
VL  - 20
IS  - 3
SP  - 292
EP  - 301
PB  - Korean Stroke Society
CY  - Seoul
ER  -