Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke

Senta Frol; Janja Pretnar Oblak; Mišo Šabovic; Wim H van Zwam; George Ntaios; Karl Olof Lövblad; Andreas Gruber; Pawel Kermer

doi:10.1177/10760296241279545

Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke

Senta Frol^*, Janja Pretnar Oblak, Mišo Šabovic, Wim H van Zwam, George Ntaios, Karl Olof Lövblad, Andreas Gruber, Pawel Kermer

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Direct oral anticoagulants (DOACs) changed stroke prevention and decreased the risk of ischemic and hemorrhagic complications in patients on oral anticoagulation (OAC) therapy. The numbers of patients prescribed DOACs has increased rapidly. Availability of specific reversal agents opened new avenues in the prevention and management of DOAC complications. An ideal specific reversal agent for a DOAC in acute stroke is an agent which lacks safety concerns and immediately reverses DOAC anticoagulation activity, thereby enabling effective treatment. Reversal of anticoagulant activity is mandatory in patients with acute ischemic stroke (AIS) before performing therapeutic procedures such as intravenous thrombolysis (IVT) and neurosurgery in intracranial hemorrhage (ICH) in order to improve clinical outcomes. In this manuscript we pursue an interdisciplinary approach in discussing advantages and concerns of specific reversal agents in acute stroke DOAC-treated patients in everyday clinical practice.

Original language	English
Pages (from-to)	1-7
Number of pages	7
Journal	Clinical and Applied Thrombosis-Hemostasis
Volume	30
DOIs	https://doi.org/10.1177/10760296241279545
Publication status	Published - 1 Jan 2024

Keywords

acute ischemic stroke
direct oral anticoagulants
intracranial hemorrhage
multidisciplinary approach
specific reversal agents
Humans
Anticoagulants/therapeutic use administration & dosage adverse effects
Stroke/drug therapy prevention & control
Administration, Oral
Ischemic Stroke/drug therapy

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title = "Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke",

abstract = "Direct oral anticoagulants (DOACs) changed stroke prevention and decreased the risk of ischemic and hemorrhagic complications in patients on oral anticoagulation (OAC) therapy. The numbers of patients prescribed DOACs has increased rapidly. Availability of specific reversal agents opened new avenues in the prevention and management of DOAC complications. An ideal specific reversal agent for a DOAC in acute stroke is an agent which lacks safety concerns and immediately reverses DOAC anticoagulation activity, thereby enabling effective treatment. Reversal of anticoagulant activity is mandatory in patients with acute ischemic stroke (AIS) before performing therapeutic procedures such as intravenous thrombolysis (IVT) and neurosurgery in intracranial hemorrhage (ICH) in order to improve clinical outcomes. In this manuscript we pursue an interdisciplinary approach in discussing advantages and concerns of specific reversal agents in acute stroke DOAC-treated patients in everyday clinical practice.",

keywords = "acute ischemic stroke, direct oral anticoagulants, intracranial hemorrhage, multidisciplinary approach, specific reversal agents, Humans, Anticoagulants/therapeutic use administration & dosage adverse effects, Stroke/drug therapy prevention & control, Administration, Oral, Ischemic Stroke/drug therapy",

author = "Senta Frol and {Pretnar Oblak}, Janja and Mi{\v s}o {\v S}abovic and {van Zwam}, {Wim H} and George Ntaios and L{\"o}vblad, {Karl Olof} and Andreas Gruber and Pawel Kermer",

year = "2024",

month = jan,

day = "1",

doi = "10.1177/10760296241279545",

language = "English",

volume = "30",

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journal = "Clinical and Applied Thrombosis-Hemostasis",

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TY - JOUR

T1 - Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke

AU - Frol, Senta

AU - Pretnar Oblak, Janja

AU - Šabovic, Mišo

AU - van Zwam, Wim H

AU - Ntaios, George

AU - Lövblad, Karl Olof

AU - Gruber, Andreas

AU - Kermer, Pawel

PY - 2024/1/1

Y1 - 2024/1/1

N2 - Direct oral anticoagulants (DOACs) changed stroke prevention and decreased the risk of ischemic and hemorrhagic complications in patients on oral anticoagulation (OAC) therapy. The numbers of patients prescribed DOACs has increased rapidly. Availability of specific reversal agents opened new avenues in the prevention and management of DOAC complications. An ideal specific reversal agent for a DOAC in acute stroke is an agent which lacks safety concerns and immediately reverses DOAC anticoagulation activity, thereby enabling effective treatment. Reversal of anticoagulant activity is mandatory in patients with acute ischemic stroke (AIS) before performing therapeutic procedures such as intravenous thrombolysis (IVT) and neurosurgery in intracranial hemorrhage (ICH) in order to improve clinical outcomes. In this manuscript we pursue an interdisciplinary approach in discussing advantages and concerns of specific reversal agents in acute stroke DOAC-treated patients in everyday clinical practice.

AB - Direct oral anticoagulants (DOACs) changed stroke prevention and decreased the risk of ischemic and hemorrhagic complications in patients on oral anticoagulation (OAC) therapy. The numbers of patients prescribed DOACs has increased rapidly. Availability of specific reversal agents opened new avenues in the prevention and management of DOAC complications. An ideal specific reversal agent for a DOAC in acute stroke is an agent which lacks safety concerns and immediately reverses DOAC anticoagulation activity, thereby enabling effective treatment. Reversal of anticoagulant activity is mandatory in patients with acute ischemic stroke (AIS) before performing therapeutic procedures such as intravenous thrombolysis (IVT) and neurosurgery in intracranial hemorrhage (ICH) in order to improve clinical outcomes. In this manuscript we pursue an interdisciplinary approach in discussing advantages and concerns of specific reversal agents in acute stroke DOAC-treated patients in everyday clinical practice.

KW - acute ischemic stroke

KW - direct oral anticoagulants

KW - intracranial hemorrhage

KW - multidisciplinary approach

KW - specific reversal agents

KW - Humans

KW - Anticoagulants/therapeutic use administration & dosage adverse effects

KW - Stroke/drug therapy prevention & control

KW - Administration, Oral

KW - Ischemic Stroke/drug therapy

U2 - 10.1177/10760296241279545

DO - 10.1177/10760296241279545

M3 - (Systematic) Review article

SN - 1076-0296

VL - 30

SP - 1

EP - 7

JO - Clinical and Applied Thrombosis-Hemostasis

JF - Clinical and Applied Thrombosis-Hemostasis

ER -

Specific Reversal Agents for Direct Oral Anticoagulants in Acute Stroke

Abstract

Keywords

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