ReviewDigestive diseases and sciences2021
Anticoagulant Reversal in Gastrointestinal Bleeding: Review of Treatment Guidelines.
Review in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Safety and efficacy of fixed versus variable-dose prothrombin complex concentrate for emergent reversal of vitamin K antagonists: A systematic review and meta-analysis.The American journal of emergency medicine · 2024Pooled it
- CytoSorb Application for Successful Control of Life-Threatening Gastrointestinal Bleeding Following Rivaroxaban Administration.The American journal of case reports · 2026Article
- Four-Factor Prothrombin Complex Concentrate vs Plasma in Patients on Vitamin K Antagonists With Gastrointestinal Bleeding or Needing a Gastrointestinal Procedure: A Retrospective Analysis of 2 Randomized Controlled Trials.Journal of the American College of Emergency Physicians open · 2025Article
- Management of gastrointestinal bleed in the intensive care setting, an updated literature review.World journal of critical care medicine · 2025Review
- Reversal of oral anticoagulation in emergency conditions.Blood transfusion = Trasfusione del sangue · 2025Article
- Article
- Risk factors and management of gastrointestinal bleeding in patients with or without antiplatelet and anticoagulation therapy: a multicenter real-world prospective study.BMC gastroenterology · 2024Article
- Comparison of mechanical and thermal therapy in upper gastrointestinal bleeding: an analysis of efficacy outcomes.Proceedings (Baylor University. Medical Center) · 2024Article
- To Bleed or Not to Bleed.Cureus · 2023Article
- [Clinical Management of Non-Variceal Upper Gastrointestinal Bleeding].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022Review
- A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding.Applied bionics and biomechanics · 2022Article
- Challenges to Laboratory Monitoring of Direct Oral Anticoagulants.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
- Narrative Review of Management Strategies and Risk Mitigation for Gastrointestinal Bleeding in Atrial Fibrillation Patients Receiving Warfarin.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPatients receiving anticoagulant therapies, such as vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), commonly experience gastrointestinal (GI) bleeding as a complication and may require anticoagulant reversal prior to endoscopic treatment. Anticoagulant reversal agents include prothrombin complex concentrates (PCCs; including 3 or 4 coagulation factors), plasma, vitamin K, and target-specific DOAC reversal agents (e.g., idarucizumab and andexanet alfa).
aimTo review current US, as well as international, guidelines for anticoagulant reversal agents in patients on VKAs or DOACs presenting with GI bleeding prior to endoscopy, guideline-based management of coagulation defects, timing of endoscopy, and recommendations for resumption of anticoagulant therapy following hemostasis. Supporting clinical data were also reviewed.
methodsThis is a narrative review, based on PubMed and Internet searches reporting GI guidelines and supporting clinical data.
resultsGI-specific guidelines state that use of reversal agents should be considered in patients with life-threatening GI bleeding. For VKA patients presenting with an international normalized ratio > 2.5, guidelines recommend PCCs (specifically 4F-PCC), as they may exhibit greater efficacy/safety compared with fresh frozen plasma in reversal of VKA-associated GI bleeding. For DOAC patients, most guidelines recommend targeted specific reversal agents in the setting of GI bleeding; however, PCCs (primarily 4F-PCC) are often listed as another option. Resumption of anticoagulant therapy following cessation of GI bleeding is also recommended to reduce risks of future thromboembolic complications.
conclusionsThe utility of anticoagulant reversal agents in GI bleeding is recognized in guidelines; however, such agents should be reserved for use in truly life-threatening scenarios.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.