PT  - JOURNAL ARTICLE
AU  - Mohammed AlSheef
AU  - Ghaydaa Kullab
AU  - Modhi Alajmi
AU  - Ruba Aldhaheri
AU  - Sultan Al Baqmi
AU  - Haya Alajlan
AU  - Abdul Rehman Z. Zaidi
AU  - Amani Abu-Shaheen
TI  - Prothrombin complex concentrate in the management of major bleeding induced by oral anticoagulant therapy
AID  - 10.15537/smj.2022.43.2.20210736
DP  - 2022 Feb 01
TA  - Saudi Medical Journal
PG  - 213--217
VI  - 43
IP  - 2
4099  - http://smj.org.sa/content/43/2/213.short
4100  - http://smj.org.sa/content/43/2/213.full
SO  - Saudi Med J2022 Feb 01; 43
AB  - Objectives: To share clinical data on the efficacy of 4F-PCC in the treatment of major bleeding caused by warfarin, dabigatran, and rivaroxaban.Methods: This is a retrospective study of patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia with major bleeding caused by oral anticoagulants and treated with 4-factor prothrombin complex concentrate (4F-PCC). The International Society of Thrombosis and Hemostasis Scientific and Standardization Subcommittee criteria were used to evaluate the effectiveness of PCCs.Results: A total of 22 patients were included in the study. Ten of the events were caused by gastrointestinal bleeding (46%). In the majority of patients, anticoagulation was prescribed for stroke prevention, atrial fibrillation, and venous thromboembolism. The median international normalized ratio was significantly lower before and after PCC administration (p<0.001). In patients treated with 4-factor PCC, the rate of thromboembolic events was 0%. The hemostatic effectiveness of PCC was effective in 19 patients. During treatment, no clinically significant bleeding complications occurred.Conclusion: Prothrombin complex concentrate can effectively reverse the effects of warfarin and rivaroxaban in patients with major bleeding, but only partially reverses the effect of dabigatran.