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Direct oral anticoagulants (DOACs) such as apixaban, dabigatran, edoxaban, and rivaroxaban are mainly used in the prevention of thromboembolic complications in patients with atrial fibrillation (AF) and in the treatment of venous thromboembolism. As compared with vitamin K antagonists (VKAs), they are characterized by at least similar efficacy and better safety profiles, especially with respect to intracranial hemorrhages. Moreover, they are more convenient therapeutic agents. The 2016 European Society of Cardiology guidelines clearly favor DOACs over VKAs in patients with AF. However, DOAC therapy is also associated with the risk of bleeding complications. The aim of this review was to provide recommendations for the management of bleeding complications during DOAC therapy in the Polish setting. The recommendations were based on the most important documents concerning this issue and were developed by representatives of different medical specialties. Experience in managing cases of bleeding on DOAC therapy is still limited. Therefore, we hope that this publication will be helpful in everyday clinical practice and that it will be useful for developing in‑hospital recommendations for the management of patients with DOAC‑related bleeding.

Introduction:  Heart failure (HF) is a growing health care problem in the world. Secondary pulmonary venous hypertension is usually observed in patients with end‑stage heart failure., Objectives:  The main purpose of the study was to evaluate the relationships between N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) levels and the markers of secondary venous pulmonary hypertension in patients referred for heart transplantation (HTX). , Patients and Methods:  This retrospective analysis included 35 patients (32 men, 3 women; median age, 55.0; interquartile range [IQR] 12.0 years). The study group consisted of all consecutive patients referred for HTX, in whom the right‑heart catheterization using the Swan‑Ganz catheter was performed at the same time as the measurement of NT‑proBNP levels., Results:  A high median value of NT‑proBNP (3187.0; IQR 2964.0 pg/ml) and elevated pulmonary pressure were observed in the study group. There was a significant correlation between NT‑proBNP levels and the values of systolic, mean, and diastolic pulmonary artery pressure (r = 0.5, P = 0.001; r = 0.5, P = 0.001; r = 0.5, P = 0.002; respectively) as well as cardiac output (r = -0.4, P = 0.007). There was also a positive correlation between pulmonary artery resistance and NT‑proBNP levels (r = 0.5, P = 0.006)., Conclusions:  In our study population, the median value of NT‑proBNP levels exceeded the normal range 25 times. There was a correlation between the markers of secondary pulmonary hypertension and cardiac output and NT‑proBNP levels. Elevated NT‑proBNP levels in patients with end‑stage HF may be associated with significant secondary venous pulmonary hypertension.