In spite of this, numerous care gaps continue to exist, highlighting the need for more streamlined and efficient processes to implement best practices in service to improved patient care.Ĭentral to the ACC’s strategic plan is the generation of “actionable knowledge”-a concept that places emphasis on making clinical information easier to consume, share, integrate, and update. In most circumstances, these documents have been created to complement clinical practice guidelines and to inform clinicians about areas where evidence may be new and evolving or where sufficient data may be more limited. The American College of Cardiology (ACC) has a long history of developing documents (e.g., decision pathways, health policy statements, appropriate use criteria) to provide members with guidance on both clinical and nonclinical topics relevant to cardiovascular (CV) care. Peer Reviewer Information - 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants 621 Restarting Anticoagulation After a Surgery/Procedure 613ĭiscussion and Implication of Pathway 614Īuthor Relationships With Industry and Other Entities (Relevant)- 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants 618 Components of the Clinician-Patient Discussion 613 Patient Engagement in Restarting Anticoagulation 610 Timing of Anticoagulation Reinitiation 609įigure 6. Original Indications for Anticoagulation With High Thrombotic Risk 610 Suggested Reversal/Hemostatic Strategy for OACs 606įactor Xa Inhibitors (Apixaban, Betrixaban, Edoxaban, and Rivaroxaban) 606Ĭonsiderations for Restarting Anticoagulation 608 Figure 4.Ĭonsiderations for Restarting Anticoagulation 609 Table 4b: Suggested Duration for Withholding DOAC Based on Bleed Risk 605 Table 4a: Estimated Drug Half-Life Based on CrCl 605 Considerations for Reversal/Hemostatic Agents 604 Suggestions for Qualitative Assessment of DOACs When Assays Suitable for Quantitation Are not Available 602įigure 3. Assays Suitable for Quantitation of DOACs 601 Overt Bleeding With Hemoglobin Drop ≥2 g/dL or Administration of ≥2 Units of Packed RBCs 600 Assessing Bleed Severity and Managing Major and Non-Major Bleeds 599
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