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Chayakrit Krittanawong: Precision Anticoagulation in the Cath Lab – What Happens when the Patient Doesn’t Look like the Trial?
Chayakrit Krittanawong/X
Sep 7, 2026, 14:41

Chayakrit Krittanawong: Precision Anticoagulation in the Cath Lab – What Happens when the Patient Doesn’t Look like the Trial?

Chayakrit Krittanawong, The ACC/AHA Joint Committee on Clinical Data Standards at American College of Cardiology, Founder of HumanX, shared a post on LinkedIn:

“Precision anticoagulation in the cath lab: What happens when the patient doesn’t look like the trial?

Following our review of intraprocedural anticoagulation in the cardiac catheterization laboratory: Part 1, I’m excited to share Part 2, focusing on patients who are often left out of the evidence.

STEMI after fibrinolysis

  • Mechanical circulatory support
  • Nonagenarians
  • Warfarin and DOAC therapy
  • Cirrhosis
  • Advanced CKD and ESRD
  • Thrombocytopenia

The challenge is simple:

The patients at highest risk of bleeding and thrombosis are often the patients with the least randomized evidence.

An elevated INR in cirrhosis doesn’t necessarily mean a patient is ‘auto-anticoagulated’.

A patient on a DOAC may still need intraprocedural anticoagulation.

Impella and ECMO require different anticoagulation strategies.

And in ESRD, nonagenarians, and thrombocytopenia, the usual risk scores may not tell the whole story.

One-size-fits-all anticoagulation doesn’t fit these patients.

The future is precision-guided anticoagulation: patient, procedure, device, and real-time risk.”

Chayakrit Krittanawong

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