By rray, 26 March, 2024 If CHA2DS2 VASc 2 or equivalent risk of stroke interrupting or continuing DOAC both acceptable A
By rray, 26 March, 2024 If thromboembolism risk 5 continue warfarin in preference to interruption and bridging A
By rray, 26 March, 2024 If reversible cause related to OAC e g high INR change in renal fxn interacting meds consider switching OAC
By rray, 26 March, 2024 If on antiplatelet tx assess need for aspirin in stable CAD or ACS reassess need for DAPT in pts after PCI and consider d c of aspirin
By rray, 26 March, 2024 If NPO awaiting invasive procedure pregnancy high risk of rebleed being bridged back to warfarin w high thrombotic risk suggest temporary or long term parenteral anticoagulation
By rray, 26 March, 2024 If ICH and high risk of recurrence cerebral amyloid angiopathy lobar intraparenchymal hemorrhage older age 10 microbleeds on MRI disseminated cortical superficial siderosis on MRI poorly controlled HTN hx of spontaneous ICH genetic acquired coagulopathy u
By rray, 26 March, 2024 If ICH in pt w AF and 5 yr risk of thromboembolic events rheumatic heart dz mech heart valve hx of stroke VTE active malignancy genetic thrombophilia CHA2DS2 VASc score 5 early resumption of OAC is reasonable to reduce thromboembolic events C LD Consider
By rray, 26 March, 2024 If major GI bleed and reversible causes corrected resuming OAC may be reasonable B NR Consider delayed restart
By rray, 26 March, 2024 If low thromboembolic risk AF w CHA2DS2 VASc 3mo prior bioprosthetic valve w o AF 3mo ago discontinuing OAC is reasonable