{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:50:39Z","timestamp":1790362239173,"version":"4.1.0"},"reference-count":75,"publisher":"Oxford University Press (OUP)","issue":"20","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,21]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Over the past 20 years, there has been a shift from vitamin K antagonists to direct oral anticoagulants (DOACs), which include the thrombin inhibitor dabigatran and the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban. Although DOACs are associated with less serious bleeding than vitamin K antagonists, bleeding still occurs with DOACs, particularly in the elderly and in those with comorbidities. Reversal of the anticoagulant effects of the DOACs may be needed in patients with serious bleeding and in those requiring urgent surgery or intervention. Reversal can be effected with specific agents, such as idarucizumab for dabigatran and andexanet alfa for apixaban, edoxaban, and rivaroxaban, or with non-specific agents, such as prothrombin complex concentrates, activated prothrombin complex concentrate, and recombinant activated factor VII. This paper (i) provides an update on when and how to reverse the DOACs, (ii) describes new reversal agents under development, and (iii) provides a strategic framework for the reversal of the factor XI inhibitors currently under investigation in phase three clinical trials.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad123","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T05:46:21Z","timestamp":1680155181000},"page":"1795-1806","source":"Crossref","is-referenced-by-count":54,"title":["Reversal agents for current and forthcoming direct oral anticoagulants"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5256-6346","authenticated-orcid":false,"given":"Nick","family":"van Es","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Pulmonary Hypertension & Thrombosis , Meibergdreef 9, 1105 AZ, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-574X","authenticated-orcid":false,"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Chair and Postgraduate School of Cardiology, University of Pisa , Lungarno Antonio Pacinotti, 43, 56126 Pisa , Italy"},{"name":"Cardiology Division, Pisa University Hospital , 56100 Pisa , Italy"},{"name":"Fondazione Villa Serena per la Ricerca, Via Leonardo Petruzzi , 42, 65013 Citt\u00e0 Sant'Angelo-Pescara , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1092-7550","authenticated-orcid":false,"given":"Jeffrey I","family":"Weitz","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University , 1200 Main St W, Hamilton, ON, Canada L8N 3Z5"},{"name":"Department of Biochemistry and Biomedical Sciences, McMaster University , Hamilton, ON, Canada L8S 4L8"},{"name":"Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University , 237 Barton St. E., Hamilton, ON, Canada L8L 2X2"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"2023052108544855400_ehad123-B1","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/S0140-6736(13)62343-0","article-title":"Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials","volume":"383","author":"Ruff","year":"2014","journal-title":"Lancet"},{"key":"2023052108544855400_ehad123-B2","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1182\/blood-2014-04-571232","article-title":"Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials","volume":"124","author":"van 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