Journal
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
Volume 14, Issue 7, Pages 1325-1327Publisher
WILEY-BLACKWELL
DOI: 10.1111/jth.13344
Keywords
factor Xa; multiphasic screening; partial thromboplastin time; prothrombin time; thrombin time
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Patients on direct oral anticoagulants (DOAC) may need interruption of treatment before surgery or invasive procedures. Owing to their favorable pharmacokinetics, DOAC could be interrupted for a fixed number of days before surgery or invasive procedures without laboratory testing. However, there are a number of issues that raise concerns about the safety of this strategy. In contrast, laboratory testing prior to surgery or invasive procedures 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 laboratory strategy appears superior in terms of patient safety and should be considered in patients undergoing surgical or invasive procedures.
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