Urol. praxi, 2013; 14(2): 77-80

Perioperative risk in the era of novel oral anticoagulants

doc.MUDr.Petr Heinc, Ph.D., doc.MUDr.Miloš Táborský, CSc., FESC, MBA, MUDr.František Kováčik, MUDr.Marie Lazárová, MUDr.Jan Přeček
I. interní klinika &ndash, kardiologická, Fakultní nemocnice Olomouc

Novel oral anticoagulants in prevention of stroke and systemic embolism in patients with atrial fibrillation are preferred since 2012.

This large cohort of patients creates specific problems of optimal hemostasis in the perioperative period. In current practice used new

anticoagulants – dabigatran (Pradaxa) and rivaroxaban (Xarelto) – do not require laboratory monitoring of anticoagulation, but we also

have no specific antidote for bleeding complications. The characteristics and management of the new anticoagulant therapy should

help to reduce the overall perioperative risk.

Keywords: perioperative risk, properties of dabigatran and rivaroxaban, bleeding risk

Published: April 1, 2013  Show citation

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Heinc P, Táborský M, Kováčik F, Lazárová M, Přeček J. Perioperative risk in the era of novel oral anticoagulants. Urol. praxi. 2013;14(2):77-80.
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References

  1. Dewilde S, Carey IM, Emmas C, et al. Trends in the prevalence of diagnosed atrial fibrillation, its treatment with anticoagulation and predictors of such treatment in UK primary care. Heart 2006; 92: 1064-1070. Go to original source... Go to PubMed...
  2. Camm AJ, Lip GYH, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2012; 33: 2719-2747. Go to original source... Go to PubMed...
  3. Connolly SJ, Ezekowitz MD, Yusuf S, et al. for the RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-1151. Go to original source... Go to PubMed...
  4. Patel MR, Mahaffey KW, Garg J, and the ROCKET AF Steering Committee for the ROCKET AF Investigators. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation. N Engl J Med 2011; 365: 883-891. Go to original source... Go to PubMed...
  5. De Caterina R, Husted S, Wallentin L, et al. Coordinating Committee. New oral anticoagulants in atrial fibrillation and acute coronary syndromes: ESC Working Group on Thrombosis-Task Force on Anticoagulants in Heart Disease position paper. J Am Coll Cardiol 2012; 59: 1413-1425. Go to original source... Go to PubMed...
  6. Douxfils J, Mullier F, Robert S, et al. Impact of dabigatran on a large panel of routine or specific coagulation assays. Laboratory recommendations for monitoring of dabigatran etexilate. Thromb Haemost 2012; 107: 985-997. Go to original source... Go to PubMed...
  7. Tripodi A. Measuring the anticoagulant effect of direct factor Xa inhibitors. Is the anti-Xa assay preferable to the prothrombin time test? Thromb Haemost 2011; 105: 735-736. Go to original source... Go to PubMed...
  8. Huisman MV, et al. Dabigatran etexilate for stroke prevention in patients with atrial fibrillation: resolving uncertainties in routine practice. Thromb Haemost 2012; 107(5): 838-847. Go to original source... Go to PubMed...
  9. Eikelboom J, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation 2011; 123(21): 2363-2672. Go to original source... Go to PubMed...
  10. Eerenberg ES, Kamphuisen PW, Sijpkens MK, et al. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation 2011; 124: 1573-1579. Go to original source... Go to PubMed...
  11. Marlu R, Hodaj E, Paris A, et al. Effect of nonspecific reversal agents on anticoagulant activity of dabigatran, rivaroxaban. A randomised crossover ex vivo study in healthy volunteers. Thromb Haemost 2012; 108: 217-224. Go to original source... Go to PubMed...
  12. van Ryn J, Neubauer M, Flieg R, et al. Successful removal of dabigatran in flowing blood with an activated charcoal hemoperfusion column in an in vitro test systém (abstract P485). Pathophysiol Haemost Thromb 2010; 57(Suppl 1): A94.




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