Cargando…
Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review
Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications,...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Libertas Academica
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156547/ https://www.ncbi.nlm.nih.gov/pubmed/28008269 http://dx.doi.org/10.4137/HSI.S40701 |
_version_ | 1782481283491823616 |
---|---|
author | Sunkara, Tagore Ofori, Emmanuel Zarubin, Vadim Caughey, Megan E. Gaduputi, Vinaya Reddy, Madhavi |
author_facet | Sunkara, Tagore Ofori, Emmanuel Zarubin, Vadim Caughey, Megan E. Gaduputi, Vinaya Reddy, Madhavi |
author_sort | Sunkara, Tagore |
collection | PubMed |
description | Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period. A total of four direct-acting oral anticoagulants were considered appropriate for inclusion in this review. The drugs were dabigatran etexilate mesylate (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa). Management of patients on DOACs in the perioperative period involves an assessment of thromboembolic event risk while off anticoagulation compared to the relative risk of bleeding if such drug is continued. DOACs may not need to be discontinued in minor surgeries or procedures, and in major surgeries, they may be discontinued hours prior depending on drug pharmacokinetics and renal function of the patients. |
format | Online Article Text |
id | pubmed-5156547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Libertas Academica |
record_format | MEDLINE/PubMed |
spelling | pubmed-51565472016-12-22 Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review Sunkara, Tagore Ofori, Emmanuel Zarubin, Vadim Caughey, Megan E. Gaduputi, Vinaya Reddy, Madhavi Health Serv Insights Review Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period. A total of four direct-acting oral anticoagulants were considered appropriate for inclusion in this review. The drugs were dabigatran etexilate mesylate (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa). Management of patients on DOACs in the perioperative period involves an assessment of thromboembolic event risk while off anticoagulation compared to the relative risk of bleeding if such drug is continued. DOACs may not need to be discontinued in minor surgeries or procedures, and in major surgeries, they may be discontinued hours prior depending on drug pharmacokinetics and renal function of the patients. Libertas Academica 2016-12-13 /pmc/articles/PMC5156547/ /pubmed/28008269 http://dx.doi.org/10.4137/HSI.S40701 Text en © 2016 the author(s), publisher and licensee Libertas Academica Ltd. This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License. |
spellingShingle | Review Sunkara, Tagore Ofori, Emmanuel Zarubin, Vadim Caughey, Megan E. Gaduputi, Vinaya Reddy, Madhavi Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review |
title | Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review |
title_full | Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review |
title_fullStr | Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review |
title_full_unstemmed | Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review |
title_short | Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review |
title_sort | perioperative management of direct oral anticoagulants (doacs): a systemic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156547/ https://www.ncbi.nlm.nih.gov/pubmed/28008269 http://dx.doi.org/10.4137/HSI.S40701 |
work_keys_str_mv | AT sunkaratagore perioperativemanagementofdirectoralanticoagulantsdoacsasystemicreview AT oforiemmanuel perioperativemanagementofdirectoralanticoagulantsdoacsasystemicreview AT zarubinvadim perioperativemanagementofdirectoralanticoagulantsdoacsasystemicreview AT caugheymegane perioperativemanagementofdirectoralanticoagulantsdoacsasystemicreview AT gaduputivinaya perioperativemanagementofdirectoralanticoagulantsdoacsasystemicreview AT reddymadhavi perioperativemanagementofdirectoralanticoagulantsdoacsasystemicreview |