Peri-procedural management of dabigatran and rivaroxaban: Duration of anticoagulant discontinuation and drug concentrations

Thrombosis Research
Anne GodierI Gouin-Thibault

Abstract

Peri-procedural management of direct oral anticoagulants (DOAC) is challenging. The optimal duration of pre-procedural discontinuation that guarantees a minimal DOAC concentration ([DOAC]) at surgery is unknown. The usual 48-hour discontinuation might not be sufficient for all patients. To test the hypothesis that a 48-hour DOAC discontinuation is not sufficient to ensure a minimal per-procedural [DOAC], defined as [DOAC]<30ng/mL. To investigate the factors associated with per-procedural [DOAC]. To evaluate the ability of normal PT and aPTT to predict [DOAC]<30ng/mL. Patients treated with dabigatran or rivaroxaban, and requiring any invasive procedure were included in this multicentre, prospective, observational study. [DOAC], PT and aPTT were measured during invasive procedure. Sixty-five patients were enrolled. Duration of DOAC discontinuation ranged from 1-168h. Per-procedural [DOAC] ranged from <30 to 466ng/mL. [DOAC]<30ng/mL occurred more frequently after 48-hour discontinuation than after a shorter delay. [DOAC] remained ≥30ng/mL in 36% and 14% of measurements performed 24-48h and 48h-120h after discontinuation, respectively. According to ROC curve, a cut-off value of 120hours for DOAC discontinuation had a better specifi...Continue Reading

References

Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Aug 31, 2012·Blood·Alex C Spyropoulos, James D Douketis
May 10, 2013·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerPiet Wyffels
Sep 13, 2014·Journal of the American College of Cardiology·Adam CukerDavid A Garcia

❮ Previous
Next ❯

Citations

Jun 15, 2016·Journal des maladies vasculaires·A GodierS Susen
Oct 25, 2016·Journal of Thrombosis and Haemostasis : JTH·A C SpyropoulosJ D Douketis
Oct 25, 2016·Journal of Thrombosis and Haemostasis : JTH·A Tripodi
Jun 2, 2017·Therapeutic Advances in Gastroenterology·David DeutschRobert Benamouzig
Nov 5, 2016·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Sarah LessireFrançois Mullier
Jan 30, 2018·European Journal of Clinical Pharmacology·Martin H J WiesenGuido Michels
Nov 5, 2019·Transfusion·Alexander KasererJan-Dirk Studt
May 19, 2017·Thrombosis Journal·Virginie DuboisSarah Lessire
Oct 30, 2018·Journal of the American Heart Association·Matthias EbnerSven Poli
Dec 2, 2017·Journal of Thrombosis and Haemostasis : JTH·J DouxfilsF Mullier
Nov 30, 2019·Case Reports in Emergency Medicine·Simone EhrhardThomas C Sauter
Feb 16, 2017·Critical Care : the Official Journal of the Critical Care Forum·Matthias EbnerSven Poli
Nov 7, 2019·Journal of Thrombosis and Thrombolysis·Florian HärtigSebastian Hörber
Jun 18, 2020·Research and Practice in Thrombosis and Haemostasis·Michael MetzeSirak Petros
Aug 20, 2017·European Heart Journal·Anne GodierIsabelle Gouin-Thibault
Jan 27, 2020·The Journal of Thoracic and Cardiovascular Surgery·Vanessa FoxIngvild Birschmann
Oct 16, 2019·Revue des maladies respiratoires·D-M SmadjaUNKNOWN groupe de travail Recommandations de bonne pratique pour la prise en charge de la MVTE
Jul 3, 2021·Journal of Clinical Medicine·Valentina RancatiCarlo Marcucci

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.