Xa-I Levels in Patients in Patients with Occult Bleeding During Chronic Treatments with Doacs

Background The increasing use of DOACs around world has been associated to an increase of patients with occult bleedings with decrease of haemoglobin > 2 g\ dL according to ISTH criteria and without overt major clinical bleeding. The use of Xa levels to screen patients at risk of major bleedings is discouraged by all scientific societies because with negative predictive value regaring that outcome; yet the same outcome is not screened in Literature for occult bleeding requiring blood trasfusion. We evaluated the outcome at 10 days and 30 days of patients admitted in internal medicine for anemia without overt bleeding dosing Xa-I during DOACs treatment. Patients and Methods 15 patients with severe anemia with needful blood trasfusion and without overt bleeding were scrrened. HB, PLT, BUN, creatinine and Xa-i levels were ruled out toghether with the type and osage of DOACs in anamnestic treatment. Results Increased Xa-I levels were associated to recent intake or decreased renal functions but not with favorable\unfavorable outcome in our cohort. Discussion The use of DOACs and the impact of occult bleedings requiring blood trasfusion are not associated with impaired levels of Xa-I