¿Qué haría usted ante un paciente con fibrilación auricular no valvular en tratamiento con anticoagulantes orales de acción directa que tiene que hacerse una gastroscopia o colonoscopia? / What would you do with a patient with non-valvular atrial fibrillation treated with direct-acting oral anticoagulants who had to undergo gastroscopy or colonoscopy?

En España aproximadamente el 25% de los pacientes anticoagulados por fibrilación auricular no valvular llevan un anticoagulante de acción directa (ACOD). Es previsible que la mayor parte de ellos en algún momento de su vida deban someterse a procedimientos invasivos o tratamientos quirúrgicos, por lo que el manejo del ACOD en estas situaciones es esencial para realizar el procedimiento con la máxima seguridad y minimizar al máximo el riesgo de hemorragia y de trombosis. El manejo de esta situación se basa en la valoración del riesgo hemorrágico del paciente y del procedimiento que se va a realizar, del riesgo de tromboembolia del paciente, su función renal y de las características farmacocinéticas de los ACOD, especialmente su vida media, el grado de eliminación renal y su pico de acción

In Spain, approximately 25% of patients anticoagulated due to non-valvular atrial fibrillation use a direct-acting anticoagulant (DOAC). It is foreseeable that most of them at some point in their lives should undergo invasive procedures or surgical treatments. This makes the management of DOAC in these situations essential in order to perform the procedure with maximum safety and minimise the risk to the maximum of haemorrhage and thrombosis. The management of this situation is based on the evaluation of the haemorrhagic risk of the patient, and the procedure to be performed, the risk of thromboembolism, and renal function. The pharmacokinetic characteristics of the DOAC also should be taken into account, especially its half-life, the degree of renal elimination and its peak action

[What would you do with a patient with non-valvular atrial fibrillation treated with direct-acting oral anticoagulants who had to undergo gastroscopy or colonoscopy?] / ¿Qué haría usted ante un paciente con fibrilación auricular no valvular en tratamiento con anticoagulantes orales de acción directa que tiene que hacerse una gastroscopia o colonoscopia?

In Spain, approximately 25% of patients anticoagulated due to non-valvular atrial fibrillation use a direct-acting anticoagulant (DOAC). It is foreseeable that most of them at some point in their lives should undergo invasive procedures or surgical treatments. This makes the management of DOAC in these situations essential in order to perform the procedure with maximum safety and minimise the risk to the maximum of haemorrhage and thrombosis. The management of this situation is based on the evaluation of the haemorrhagic risk of the patient, and the procedure to be performed, the risk of thromboembolism, and renal function. The pharmacokinetic characteristics of the DOAC also should be taken into account, especially its half-life, the degree of renal elimination and its peak action.