Satyendra Dhar, MD @DharSaty · 23 hours ago
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The recommended pre-operative workup for patients taking anticoagulants involves stratifying both thromboembolic & bleeding risk, determining
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The recommended pre-operative workup for patients taking anticoagulants involves stratifying both thromboembolic & bleeding risk, determining appropriate timing for medication interruption, & deciding whether bridging therapy is needed. Specific approach depends on the type of anticoagulant, renal function, and procedure-related bleeding risk.

•	Direct Oral Anticoagulants (DOACs)
o	For apixaban, rivaroxaban, and Edoxaban, the American College of Chest Physicians recommends stopping these agents 1-2 days before low-to-moderate bleeding risk procedures and 2 days before high bleeding risk procedures.

•	For dabigatran, interruption timing depends on renal function. 
o	With normal renal function (CrCl ≥50 mL/min), stop 1-2 days before low-risk procedures and 2 days before high-risk procedures. 
o	With impaired renal function (CrCl <50 mL/min), extend interruption to 3-4 days before high-risk procedures due to predominantly renal clearance.

#apixaban #rivaroxaban #Edoxaban #dabigatran #DOACs #preoperative #perioperative #Warfarin #CHA₂DS₂-VASc #antithrombotic #anticoagulant #guidelines
Satyendra Dhar, MD @DharSaty · 23 hours ago
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