A 67-year-old takes apixaban 5 mg twice daily for non-valvular atrial fibrillation. Creatinine clearance is 72 mL/min and he is scheduled for diagnost...

Question

A 67-year-old takes apixaban 5 mg twice daily for non-valvular atrial fibrillation. Creatinine clearance is 72 mL/min and he is scheduled for diagnostic gastroscopy without biopsy, classified as a low-risk endoscopic procedure. Which pre-procedure plan is most appropriate?

Accepted Answer

Continue apixaban until the procedure day and omit the morning dose

Answer

Continue apixaban including the morning dose on the procedure day

Answer

Omit apixaban for five doses before the procedure and use LMWH bridging

Answer

Omit apixaban for three doses before the procedure and use LMWH bridging

Answer

Stop apixaban seven days before the procedure and start unfractionated heparin

Perioperative Anticoagulation (DOAC) — MRCP Part 1 MCQ

A 67-year-old takes apixaban 5 mg twice daily for non-valvular atrial fibrillation. Creatinine clearance is 72 mL/min and he is scheduled for diagnostic gastroscopy without biopsy, classified as a low-risk endoscopic procedure. Which pre-procedure plan is most appropriate?