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
