New oral anticoagulants and view of a gastroenterologist – risk of gastrointestinal bleeding
Until recently, the primary option for oral anticoagulation was warfarin, which requires laboratory monitoring and dose adjustment.
New oral anticoagulants (NOACs) (thrombin and factor Xa inhibitors - dabigatran, rixaroxaban and apixaban), with
their fast growth of usage, provide an alternative to warfarin. They have a predictable effect without the need for monitoring,
less food and drug-drug interactions, shorter plasma half-life, and an improved efficacy/safety ratio. They have been
shown to be as effective for stroke prevention in patients with atrial fibrillation, for thromboprophylaxis after orthopaedic
surgery and treatment of venous thrombosis as current therapy. Some randomized controlled trials reported an isolated
higher risk for gastrointestinal bleeding, which is potentially fatal, costly and avoidable. It is therefore important to identify
risk groups and states to prevent these bleeding. In the case of bleeding correct patient´s management is needed.