del Molino Fátima, Gonzalez Isabel, Saperas Esteve
Servicio de Médicina Interna, IDC Clínica del Vallés, Sabadell, Barcelona, España; Comité de Enfermedad Tromboembólica y Anticoagulación de IDC Hospitales de Cataluña.
Comité de Enfermedad Tromboembólica y Anticoagulación de IDC Hospitales de Cataluña; Servicio de Hematología y Hemoterapia BST, Hospital Mútua de Terrassa, Tarrasa, España.
Gastroenterol Hepatol. 2015 Oct;38(8):501-10. doi: 10.1016/j.gastrohep.2015.02.014. Epub 2015 Apr 21.
New oral direct anticoagulants agents are alternatives to warfarin for long-term anticoagulation in a growing number of patients that require long-term anticoagulation for atrial fibrillation, deep venous thrombosis and pulmonary embolism. These new agents with predictable pharmacokinetic and pharmacodynamics profiles offer a favorable global safety profile, but increased gastrointestinal bleeding compared to the vitamin K antagonists. Many gastroenterologists are unfamiliar and may be wary of these newer drugs, since Clinical experience is limited and no specific antidote is available to reverse their anticoagulant effect. In this article the risk of these new agents and, how to manage these agents in both the presence of acute gastrointestinal bleeding and in patients undergoing endoscopic procedures is reviewed.
对于越来越多因心房颤动、深静脉血栓形成和肺栓塞而需要长期抗凝治疗的患者，新型口服直接抗凝剂可作为华法林进行长期抗凝治疗的替代药物。这些具有可预测药代动力学和药效学特征的新型药物具有良好的整体安全性，但与维生素K拮抗剂相比，胃肠道出血风险增加。许多胃肠病学家对这些新药并不熟悉，可能会对此持谨慎态度，因为临床经验有限，且尚无特异性解毒剂可逆转其抗凝作用。本文将对这些新药的风险以及在急性胃肠道出血情况下和接受内镜检查的患者中如何使用这些药物进行综述。
