Introduction

摘要

The new, direct oral anticoagulants (DOACs) offer safety, efficacy, and convenience advantages in comparison with the long-familiar vitamin K antagonists (VKAs). Accordingly, they have enjoyed rapid uptake around the world, and it is expected that in most settings the DOACs will replace VKAs for the prevention and management of stroke, systemic embolism, and venous thrombosis. The pharmacology, laboratory evaluation, and reversal strategies for the DOACs are different from those for VKAs and indeed vary from DOAC to DOAC. This new knowledge must be acquired by DOAC prescribers, and also by physicians—notably and most commonly gastroenterologists—who must manage unavoidable anticoagulant-associated bleeding complications.