Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Clinical Sciences and Community Health, Università degli Studi di Milano and IRCCS Cà Granda Maggiore Hospital Foundation, Milan, Italy.
J Thromb Haemost. 2016 Jul;14(7):1325-7. doi: 10.1111/jth.13344. Epub 2016 Jun 13.
Patients on direct oral anticoagulants (DOAC) may need interruption of treatment before surgery or invasive procedures. Owing to their favorable pharmacokinetics, DOAC could be interrupted for a fixed number of days before surgery or invasive procedures without laboratory testing. However, there are a number of issues that raise concerns about the safety of this strategy. In contrast, laboratory testing prior to surgery or invasive procedures would provide a direct assessment of the residual drug concentration and minimize the risk of bleeding. This forum is aimed at discussing the pros and cons of the two strategies and fostering discussion on this important issue. Overall, the laboratory strategy appears superior in terms of patient safety and should be considered in patients undergoing surgical or invasive procedures.
接受直接口服抗凝剂（DOAC）治疗的患者在接受手术或有创操作前可能需要中断治疗。由于 DOAC 的药代动力学特征良好，在手术或有创操作前可中断固定天数，而无需实验室检测。然而，有许多问题引起了人们对这种策略安全性的关注。相比之下，手术或有创操作前进行实验室检测可直接评估残留药物浓度，最大限度降低出血风险。本次论坛旨在讨论这两种策略的优缺点，并就这一重要问题展开讨论。总体而言，实验室策略在患者安全性方面表现更优，应考虑在接受手术或有创操作的患者中应用。
