What is the clinical evidence from this study?

Study design: Systematic Review. Population: Adult patients undergoing cardiac surgery taking DOACs. Intervention: Management of DOACs (cessation, monitoring, bridging, reversal, resumption). Primary outcome: Summary statements to guide care.

What does this research mean for the field?

Expert consensus was established to guide safe management of adult cardiac surgery patients on direct oral anticoagulants, enhancing patient safety and outcomes. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To establish guidelines for managing direct oral anticoagulants in adults undergoing cardiac surgery.

February 2, 2026

Management of Direct Oral Anticoagulants in Adult Patients Undergoing Cardiac Surgery: A Joint Consensus Statement by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons

Key Result

A joint consensus statement by the SCA and STS provides evidence- and expert-based summary statements to guide the management of DOACs in adult patients undergoing cardiac surgery.

Key Points

To establish guidelines for managing direct oral anticoagulants in adults undergoing cardiac surgery.
Conducted a systematic review of existing literature on DOAC management.
Reviewed options for monitoring DOAC levels and the need for bridging and reversal agents.
Facilitated an expert consensus to develop summary statements for patient care.
Summary statements guide the management of DOAC use in cardiac surgery.
Recommendations aim to improve patient safety and surgical outcomes.
Addressed the cessation and resumption of DOACs before and after surgery.

Study Design

Type

Systematic Review

Structured PICO

Population

Adult patients undergoing cardiac surgery who are taking direct oral anticoagulants.

Intervention

Perioperative management of DOACs, including cessation before surgery, monitoring options, bridging, reversal agents, and resumption after surgery

This joint consensus statement provides evidence- and expert-based guidance on the perioperative management of DOACs in adult cardiac surgery patients to enhance patient safety and outcomes.

Abstract

The Society of Cardiovascular Anesthesiologists (SCA) along with the Society of Thoracic Surgeons (STS) sought to improve the care of adult patients undergoing cardiac surgery who are taking direct oral anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors. To fulfill this, a systematic review of the literature on cessation of DOACs before cardiac surgery, options for monitoring DOACs, the need for bridging, reversal agents, and resuming the medications after surgery was performed. Additionally, an expert consensus around the management of these patients was completed. Summary statements were created using evidence and expert consensus to guide care of patients in each of these domains, with the ultimate goal to enhance patient safety and outcomes.

KI fragen

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