García-Frade RLF

Language: Spanish
References: 4
Page: 209-212
PDF size: 532.78 Kb.

ABSTRACT

In all current indications, administration of dabigatran provides effective anticoagulation with favorable bleeding profile without laboratory monitoring. However, the use of any anticoagulant increases the risk of bleeding, the anticoagulant effect of vitamin K antagonists is usually reversed in emergency situations with combinations of fresh frozen plasma, vitamin K, prothrombin complex concentrate or recombinant factor VII. However non-coumarin oral anticoagulants (AONC, new oral anticoagulants) have a short half-life and short duration of its anticoagulant effect, it has been developed a specific antidote against dabigatran. Idarucizumab reverses the inhibition in the formation of fibrin dabigatran induced in healthy volunteers and this correlates with a correction of systemic anticoagulation. Translation to reverse bleeding in patients requires clinical investigations currently ongoing, so we hope to have soon this extra resource for the safety of our patients that at any given time require it.

REFERENCES

1. Majeed A, Hwang H, Connolly S, et al. Management and outcomes of major bleeding during treatment with dabigatran or warfarin. Circulation 2013;128:2325-2332.

2. García-Frade LF, Solís E. Los nuevos anticoagulantes orales: una realidad. Med Int Mex 2013;29.

3. Schiele F, van Ryn J, Canada K, Newsome C, et al. A specific antidote for dabigatran: functional and structural characterization. Blood 2013;121:3554-3562.

4. van Ryn J, Schmohl M, Pillu H, et al. Effect of dabigatran on the ability to generate fibrin at a wound site and its reversal by idarucizumab, the antidote to dabigatran, in healthy volunteers: an exploratory marker of blood loss. 87th Sci Sess 2014 of the American Heart Association (AHA), Chicago, 15-19 Nov 2014 (Poster).