The Department of Medicine at Staten Island University Hospital, Northwell Health, USA.
The Department of Cardiology at Staten Island University Hospital, Northwell Health, USA.
Can J Gastroenterol Hepatol. 2019 Jan 8;2019:4383269. doi: 10.1155/2019/4383269. eCollection 2019.
The introduction of Direct Oral Anticoagulants (DOACs) to the pharmaceutical market provided patients and clinicians with novel convenient and safe options of anticoagulation. The use of this class of medications is currently limited to venous thromboembolic therapy and prophylaxis, in addition to stroke prophylaxis in patients with nonvalvular atrial fibrillation. Despite their altered hemostasis, patients with cirrhosis are thought to be in a procoagulant state and thus prone to thrombus formation. Patients with cirrhosis might benefit from the convenience of DOACs; however, the medical literature includes limited data on the efficacy and safety of DOACs in this special patient population. The aim of this review is to summarize the current evidence for anticoagulation options in patients with cirrhosis and their safety profile.
直接口服抗凝剂（DOACs）在医药市场的引入为患者和临床医生提供了新型的、方便且安全的抗凝选择。该类药物的使用目前仅限于静脉血栓栓塞症的治疗和预防，以及非瓣膜性心房颤动患者的卒中预防。尽管它们改变了止血功能，但患有肝硬化的患者被认为处于促凝状态，因此容易形成血栓。患有肝硬化的患者可能会受益于 DOAC 的便利性；然而，医学文献中关于 DOAC 在这一特殊患者群体中的疗效和安全性的数据有限。本综述的目的是总结目前关于肝硬化患者抗凝选择及其安全性概况的证据。
