Emerging Issues in Anticoagulation | The EM & Acute Care Course

Emerging Issues in Anticoagulation by William Mallon, MD

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Key Points and Recommendations

1. Literature supporting the safety of outpatient VTE management is weak and small, but it exists.
2. Outpatient PE management is gaining traction and may be coming to your ED soon.
3. DOACs are widely regarded as being as good or better for thromboembolic event prevention.
4. DOACs are also widely regarded as causing less bleeding.
5. Warfarin is still a perfectly viable, cheaper, and arguably just-as-good-or-maybe-better option.
6. Some DOAC data is known to have been falsified and this has infected many reviews and policies.
7. When prescribing anticoagulants from the ED apixaban, dabigatran, and rivaroxaban all have studies supporting their use for either VTE or AF.
8. Bleeding risk can’t be accurately predicted, but risk exists and this should be communicated.
9. The HAS-BLED score is probably the most supported tool for discussing and sharing this information.

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