Management of the Gastrointestinal System Bleeding Caused by Direct-Acting Oral Anticoagulants

Abstract

Direct-acting oral anticoagulants include dabigatran, which is a thrombin inhibitor, and rivaroxaban, apixaban, and edoxaban, which are anti-Xa agents. These are administered in the secondary prophylaxis and treatment of venous thromboembolism (VTE) and pulmonary embolism (PE), in the prophylaxis of VTE that may develop after major elective orthopedic surgery, in reducing stroke and systemic embolism that may occur in non-valvular atrial fibrillation, whereas its use in acute coronary syndrome is still controversial. Although it is specified that direct-acting oral anticoagulants are as effective as heparin therapy and reduce the risk of bleeding due to all causes, many important studies have also reported that they increase the risk of gastrointestinal system (GIS) bleeding.