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Would you consider using DOACs as a bridge to warfarin instead of heparin or LMWH?
For example, would you consider this method in an ESRD/HD patient with antiphospholipid syndrome who had a major bleed requiring reversal of warfarin that then needs to be bridged back to warfarin after bleeding is stabilized.
Answer from: at Academic Institution
This is an interesting question. My bias would be to bridge back to warfarin under cover of IV unfractionated heparin. Each DOAC has a different elimination route with approximate renal elimination as follows: dabigatran: 80%; edoxaban: 50%; rivaroxaban: 33%; apixaban: 25%. [PMID: 39223697].&nb...
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