Management of bleeding on NOACs – an expert consensus decision pathway by ACC
This expert consensus decision pathway (ECDP) focuses on management of bleedings in patients treated with non-vitamin K oral anticoagulants (NOACs or direct-acting oral anticoagulants; DOACs) and VKAs for any indication. In addition, the role and management of antiplatelet therapies is considered in treatment algorithms. Recommendations provided in this ECDP include guidance for temporary or permanent interruption of therapy, general approaches to bleeding management, decision support for treatment with a reversal agent and indications and timing for reinitiating anticoagulant therapy.
This is an update of the original 2017 ECDP and now includes guidance for use of new anticoagulants for use in prevention of VTE and new reversal strategies for FXa inhibitors.
ECDPs represent a key component of “solution sets”. Solution sets are groups of closely related activities, policy, mobile applications, decision support and other tools that are necessary to transform care and/or improve outcomes. So instead of developing isolated documents the ACC has moved towards development of integrated solution sets.