Risk Factors of Gastrointestinal Bleeding in Patients Receiving New Oral Anticoagulants
Korean J Helicobacter Up Gastrointest Res 2018;18(4):219-224
Published online December 10, 2018
© 2018 Korean College of Helicobacter and Upper Gastrointestinal Research.

Ju Yup Lee

Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
Correspondence to: Ju Yup Lee
Division of Gastroenterology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea
Tel: +82-53-250-7088, Fax: +82-53-250-7442, E-mail: leejygi@naver.com
Received February 22, 2018; Revised April 28, 2018; Accepted April 29, 2018.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research is an Open-Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
New oral anticoagulants (NOACs) are now widely used for the prevention and treatment of venous thrombosis, and for the prevention of stroke and systemic embolism in patients with atrial fibrillation. As compared with warfarin, NOACs have the advantage of rapid onset of action and less drug interaction. However, they carry a higher risk of gastrointestinal (GI) bleeding than warfarin. The risk of GI bleeding in patients using NOACs varies according to the type and dose of the drug. By contrast, apixaban and edoxaban are reported to carry similar risks as warfarin, and the risks with dabigatran and rivaroxaban are higher than that with warfarin. In patients using NOACs, old age, impaired renal function, impaired liver function, concurrent use of antiplatelet agents, and non-steroidal anti-inflammatory drugs are considered major risk factors of GI bleeding, and gastroprotective agents such as histamine-2 receptor antagonist and proton pump inhibitor have preventive effects. To prevent GI bleeding associated with NOACs, the characteristics of each NOAC and the risk factors of bleeding should be recognized.
Keywords : Apixaban, Dabigatran, Edoxaban, Gastrointestinal hemorrhage, Rivaroxaban


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