![]() ![]() ![]() Healthcare institutions should adopt a NOAC reversal and perioperative management protocol developed with multidisciplinary input.Īs the US population ages, the burden of atrial fibrillation (AF) and venous thromboembolic disease is expected to increase, and prescriptions for long-term anticoagulation will climb. Prothrombin concentrate may be considered in life-threatening bleeding. At present, there is no specific antidote available in the United States for the oral factor Xa inhibitors. Idarucizumab is available as an antidote to rapidly reverse the effects of dabigatran. Knowledge of time of last ingestion of the NOAC and renal function is critical to managing these patients given that laboratory measurement is challenging because of the lack of commercially available assays in the United States. Clinical trial data related to NOAC reversal for bleeding and perioperative management are sparse, and recommendations are largely derived from expert opinion. In clinical practice, there is still widespread uncertainty on how to manage patients on NOACs who bleed or who are at risk for bleeding. Non–vitamin K oral anticoagulants (NOACs) are now widely used as alternatives to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology. ![]() Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB). ![]()
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