期刊
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
卷 9, 期 9, 页码 1705-1712出版社
WILEY
DOI: 10.1111/j.1538-7836.2011.04432.x
关键词
anticoagulants; anti-IIa agents; anti-Xa agents; aspirin; hemorrhage; heparin; pentasaccharides; thienopyridine derivatives; vitamin K antagonists
The most important adverse effect of antithrombotic treatment is the occurrence of bleeding. In the case of severe bleeding in a patient who uses anticoagulant agents or when a patient on anticoagulants needs to undergo an urgent invasive procedure, it may be useful to reverse anticoagulant treatment. Conventional anticoagulants such as vitamin K antagonists may be neutralized by administration of vitamin K or prothrombin complex concentrates, whereas heparin and heparin derivatives can be counteracted by protamine sulphate. The anti-hemostatic effect of aspirin and other antiplatelet strategies can be corrected by the administration of platelet concentrate and/or desmopressin, if needed. Recently, a new generation of anticoagulants with a greater specificity towards activated coagulation factors as well as new antiplatelet agents have been introduced and these drugs show promising results in clinical studies. A limitation of these new agents may be the lack of an appropriate strategy to reverse the effect if a bleeding event occurs, although experimental studies show hopeful results for some of these agents.
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