From the Medical Specialties Department (AlSheef), from the Internal Medicine Department (Kullab), from the Research Center (Abu-Shaheen), King Fahad Medical City; from the Internal Medicine Department (Kullab, Zaidi), Dr. Sulaiman Al Habib Medical Group, Riyadh; from the College of Medicine (Al Baqmi), King Saud Bin Abdulaziz University for Health Sciences; from the College of Health and Rehabilitation Sciences (Alajlan), Princess Noura Bint Mohammed University, Riyadh; from the College of Medicine (Alajmi), Imam Abdulrahman Bin Faisal University, Dammam; and from the College of Medicine (Aldhaheri), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Saudi Med J. 2022 Feb;43(2):213-217. doi: 10.15537/smj.2022.43.2.20210736.
To share clinical data on the efficacy of 4F-PCC in the treatment of major bleeding caused by warfarin, dabigatran, and rivaroxaban.
This is a retrospective study of patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia with major bleeding caused by oral anticoagulants and treated with 4-factor prothrombin complex concentrate (4F-PCC). The International Society of Thrombosis and Hemostasis Scientific and Standardization Subcommittee criteria were used to evaluate the effectiveness of PCCs.
A total of 22 patients were included in the study. Ten of the events were caused by gastrointestinal bleeding (46%). In the majority of patients, anticoagulation was prescribed for stroke prevention, atrial fibrillation, and venous thromboembolism. The median international normalized ratio was significantly lower before and after PCC administration (<0.001). In patients treated with 4-factor PCC, the rate of thromboembolic events was 0%. The hemostatic effectiveness of PCC was effective in 19 patients. During treatment, no clinically significant bleeding complications occurred.
Prothrombin complex concentrate can effectively reverse the effects of warfarin and rivaroxaban in patients with major bleeding, but only partially reverses the effect of dabigatran.
分享 4F-PCC 在治疗华法林、达比加群和利伐沙班引起的大出血方面的疗效临床数据。
这是一项回顾性研究，纳入了在沙特阿拉伯利雅得法赫德国王医疗城因口服抗凝剂引起大出血并接受 4 因子凝血酶原复合物浓缩物（4F-PCC）治疗的患者。国际血栓形成和止血科学与标准化小组委员会标准用于评估 PCC 的疗效。
研究共纳入 22 名患者。10 起事件由胃肠道出血引起（46%）。大多数患者因预防中风、心房颤动和静脉血栓栓塞症而开具抗凝治疗。PCC 给药前后国际标准化比值明显降低（<0.001）。在接受 4 因子 PCC 治疗的患者中，血栓栓塞事件发生率为 0%。PCC 的止血效果在 19 名患者中有效。在治疗期间，未发生临床上明显的出血并发症。
凝血酶原复合物浓缩物可有效逆转大出血患者华法林和利伐沙班的作用，但仅部分逆转达比加群的作用。
