Background: The direct oral anticoagulants (DOACs) apixaban and rivaroxaban are increasingly prescribed due to convenient oral formulation without the need for routine laboratory monitoring and are now commonly regarded as first line anticoagulants in most cases of venous thromboembolism (VTE). However, the optimal choice of subsequent anticoagulant in instances of first line DOAC failure is [...]

Background: Role of vitamin K antagonist (VKA) or Direct Oral anticoagulation (DOAC) for non-valvular atrial fibrillation has widely been discussed. But the literature on anticoagulation therapy for patients with valvular atrial fibrillation (VAF) is limited. Aim of this meta-analysis was to evaluate the outcomes (stroke-vascular events and intracranial bleeding) following DOAC and VKA amongst patients [...]

Background: Over 6 million people in the US have a diagnosis of atrial fibrillation. Given the increased risk for stroke and systemic embolism, many patients are treated with direct oral anticoagulants (DOACs) to reduce their risk. In the major trials comparing to DOACs to warfarin for stroke and systemic embolism prevention in atrial fibrillation, DOACs [...]

Background: Cancer-associated thrombosis (CAT) is a common complication in patients with malignancy. Management of venous thromboembolism (VTE), in these patients, is challenging due to the high risk of recurrence and inherent risk of bleeding in this population. Direct oral anticoagulants (DOACs) have emerged as a treatment options for CAT. As yet there have not been [...]

Background: Venous thromboembolism (VTE) in hospitalized medically ill patients is a leading preventable cause of morbidity and mortality in the United States. About half of VTE events occur following discontinuation of standard-duration in-hospital prophylaxis and hospital discharge. The APEX study evaluated Betrixaban for in-hospital to home VTE prophylaxis and is the first FDA approved anticoagulant [...]

Background: Hospitalized patients receiving direct oral anticoagulants (DOACs) sometimes require bridging with unfractionated heparin (UFH). Monitoring UFH with anti-Xa assays has been shown to correlate with better outcomes. However, DOACs interfere with anti-Xa assays resulting in inappropriate UFH dose adjustments that can negatively impact patient care. In 2015, we deployed an electronic health record (EHR) [...]

Background: Direct acting oral anticoagulants (DOACs) have been approved for conditions such as non-valvular atrial fibrillation and venous thromboembolism. High quality randomized controlled trials have demonstrated the safety and efficacy of DOACs as compared to warfarin with exceptions in specific patient populations (such as those with mechanical heart valves). DOACs are more convenient and generally [...]

Case Presentation: A 46-year-old female presented with a 2-day history of shortness of breath, pleuritic chest pain and lower extremity swelling while taking low-molecular weight heparin (LMWH). One month prior she was diagnosed with a left lower extremity DVT after a hysterectomy. She was treated with LMWH with a planned transition to rivaroxaban. Medical history [...]

Case Presentation: Our patient is a 51-year-old male with PMHx of tobacco abuse who presented to the emergency room (ER) with left flank pain for 1 month. He was involved in a motor vehicle collision while driving his motorcycle four weeks ago. He initially presented to an urgent care for pain where he was found [...]