Alfonso J. Tafur: Insights on Periprocedural DOAC Management in Atrial Fibrillation at ISTH 2026
Alfonso J. Tafur, Board Member VAS European Independent Foundation in Angiology and Vasculearn Network, shared a post on LinkedIn:
”Real-world patterns of periprocedural DOAC management in patients with atrial fibrillation undergoing colonoscopy.
Using a large U.S. claims database, we found substantial variability in the timing of DOAC resumption after colonoscopy, with many patients restarting anticoagulation later than would be expected from contemporary guideline recommendations.
We highlight the gap that can exist between evidence-based recommendations and real-world clinical practice.
The implications extend beyond colonoscopy.
Delayed or inconsistent anticoagulation resumption may expose patients to avoidable thromboembolic risk, while premature resumption may increase bleeding risk.
These findings reinforce the need for structured anticoagulation stewardship programs that standardize peri-procedural management through multidisciplinary protocols, patient education, decision-support tools within the electronic health record, and coordinated communication among gastroenterology, cardiology, vascular medicine, primary care, and pharmacy.
As healthcare systems increasingly focus on quality and value, anticoagulation stewardship represents an important opportunity to improve patient safety, reduce unwarranted practice variation, and enhance adherence to evidence-based care.”
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