Bleeding During Oral Anticoagulation

[摘要] My aunt, who had to take anticoagulants, died froma brain hemorrhage—should I still . . .?” Thisreaction, which all doctors will have heard insome shape or form when they advise a patient to takeoral anticoagulants for the long term, articulates patients’fear of hemorrhage as a relevant adverse effect of thistreatment. Indeed, the fear is justified as has been shownby data from clinical studies of the effectiveness and ratesof adverse effects of anticoagulant treatment using vitamin K antagonists (VKAs) or direct oral coagulants(DOACs) (1–4). Although especially the rate of intra -cranial hemorrhages, a high percentage of which result inlasting physical disabilities or even death, is notablylower for the new DOACs than for treatment using VKAs,the long term use of DOACs has also been associated withinstances of life-threatening or fatal hemorrhage (5).

[学科分类] 医学（综合）