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Bleeding related to non-vitamin K antagonist oral anticoagulants in emergency department: A “Real-world” snapshot from Southern Italy. On behalf of MIRC-NOAC study group

Published:November 01, 2017DOI:https://doi.org/10.1016/j.ejim.2017.10.018
      The introduction of non-vitamin K antagonist oral anticoagulants (NOAC) in antithrombotic therapy is one of the major recent milestones in the general pharmacopeia [
      • Kirchhof P.
      • Benussi S.
      • Kotecha D.
      • Ahlsson A.
      • Atar D.
      • Casadei B.
      • et al.
      2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS.
      ]. Despite several papers about real-life use and impact of NOACs have been published, showing overall consistency with data reported in the RCTs, data coming from Italian daily clinical practice are still scarce [
      • Giustozzi M.
      • Vedovati M.C.
      • Verdecchia P.
      • Pierpaoli L.
      • Verso M.
      • Conti S.
      • et al.
      Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life.
      ,
      • Proietti M.
      • Marra A.M.
      • Tassone E.J.
      • De Vuono S.
      • Corrao S.
      • Gobbi P.
      • et al.
      Frequency of left ventricular hypertrophy in non-valvular atrial fibrillation.
      ]. To improve the knowledge about the real impact of NOACs-related bleeding events admission to emergency department (ED), we performed a retrospective chart search collecting all available clinical and laboratory variables from medical records of patients taking NOACs admitted into the largest tertiary hospital in Southern Italy for any kind of bleeding event. Bleeding events were categorized in 4 groups: intracranial hemorrhage (ICH), gastrointestinal bleeding (GIB), genitourinary bleeding (GUB) and mixed (i.e. epistaxis, spleen bleeding, minor oral bleeding).
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