Title:To Bleed or Not to Bleed: That is the Question. The Side Effects of Apixaban
Volume: 19
Issue: 6
Author(s): Marco Matteo Ciccone*, Annapaola Zito, Fiorella Devito, Maria Maiello and Pasquale Palmiero
Affiliation:
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari,Italy
Keywords:
Apixaban, extracranial, intracranial bleeding, anticoagulant, thrombosis, artial fibrillation.
Abstract: Apixaban is a new oral anticoagulant (NOACs: Novel Oral Anticoagulant), like dabigatran,
rivaroxaban, and edoxaban. All of them are prescribed to patients with non valvular atrial fibrillation
or venous thromboembolism, to replace warfarin, because of the lower probability of bleeding, however
they can cause bleeding by themselves. Bleeding is an adverse event in patients taking anticoagulants.
It is associated with a significant increase of morbidity and risk of death. However, these drugs
should be used only for the time when anticoagulation is strictly required, especially when used for
preventing deep vein thrombosis. Prolonged use increases the risk of bleeding. In the ARISTOTLE
Trial Apixaban, compared with warfarin, was associated with a lower rate of intracranial hemorrhages
and less adverse consequences following extracranial hemorrhage. Many physicians still have limited
experience with new oral anticoagulants and about bleeding risk managment. We reviewed the available
literature on extracranial and intracranial bleeding concerning apixaban.
