Vaskulárna medicína 1/2019

Chosen problems in management of DOACs from cardiologist point of view

Direct oral anticoagulants (DOACs) are currently preferred for pharmacologic prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Direct thrombin inhibitor dabigatran and several direct factor Xa inhibitors are recently available for clinical use, from these rivaroxaban and apixaban are the most frequently used agents. There are several new questions connected with DOAC therapy, and there is also a lack of evidence based data for their satisfactory responding. These include the problem of therapeutic on treatment levels, reversal strategies for DOAC-induced bleeding and the use of DOACs to treat other thrombotic diseases than atrial fibrillation. The article discusses these chosen clinical problems connected with DOAC therapy.

Keywords: direct oral anticoagulants; therapeutic DOAC levels, reversal strategies; heparin induced thrombocytopenia