• Sarah Lessire, Lessire Sarah, Anne-Sophie Dincq, Dincq Anne-Sophie, Jonathan Douxfils, Douxfils Jonathan, Bérangère Devalet, Devalet Bérangère, Jean-Baptiste Nicolas, Nicolas Jean-Baptiste, Anne Spinewine, Spinewine Anne, Anne-Sophie Larock, Larock Anne-Sophie, Jean-Michel Dogné, Dogné Jean-Michel, Maximilien Gourdin, Gourdin Maximilien, François Mullier, and Mullier François.
• Department of Anesthesiology, CHU Dinant-Godinne UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), NAmur Research Institute of Life Sciences (NARILIS), 5530 Yvoir, Belgium ; Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), NAmur Research Institute of Life Sciences (NARILIS), University of Namur, 5000 Namur, Belgium.
• Biomed Res Int. 2014 Jan 1; 2014: 616405.

AbstractDabigatran etexilate (DE), rivaroxaban, and apixaban are nonvitamin K antagonist oral anticoagulants (NOACs) that have been compared in clinical trials with existing anticoagulants (warfarin and enoxaparin) in several indications for the prevention and treatment of thrombotic events. All NOACs presented bleeding events despite a careful selection and control of patients. Compared with warfarin, NOACs had a decreased risk of intracranial hemorrhage, and apixaban and DE (110 mg BID) had a decreased risk of major bleeding from any site. Rivaroxaban and DE showed an increased risk of major gastrointestinal bleeding compared with warfarin. Developing strategies to minimize the risk of bleeding is essential, as major bleedings are reported in clinical practice and specific antidotes are currently not available. In this paper, the following preventive approaches are reviewed: improvement of appropriate prescription, identification of modifiable bleeding risk factors, tailoring NOAC's dose, dealing with a missed dose as well as adhesion to switching, bridging and anesthetic procedures.

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