To measure or not to measure direct oral anticoagulants before surgery or invasive procedures.
J Thromb Haemost. 2016 Apr 20;
Authors: Tripodi A
Patients on direct oral anticoagulants (DOAC) may need interruption of treatment before surgery/invasive procedures. Owing to their favorable pharmacokinetics, DOAC could be interrupted a fixed number of days before surgery/invasive procedures without lab testing. However, there are numbers of issues that raise concerns about the safety of this strategy. In contrast, lab testing prior to surgery/invasive procedure would provide a direct assessment of the residual drug concentration and minimize the risk of bleeding. This forum is aimed at discussing the pros and cons of the two strategies and fostering discussion on this important issue. Overall, the lab-strategy appears superior in terms of patient safety and should be considered in patients undergoing surgical/invasive procedures. This article is protected by copyright. All rights reserved.
PMID: 27094864 [PubMed - as supplied by publisher]