First guide for managing bleeding with NOACs

Recommendations include when to use reversal agents

The clinical problem of managing acute bleeding in patients taking anticoagulants is addressed in a new guidance by US cardiology experts.

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The evidence-based guidelines pertain to both non-vitamin K oral anticoagulants (NOACs), such as dabigatran, apixaban and rivaroxaban, and vitamin K antagonists (VKAs), such as warfarin.

The decision pathway considers the severity of the bleed (major vs non-major), the need for reversal, and the appropriateness and time of restarting anticoagulation.

Here are some of the main recommendations for controlling a major

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