Managing Dabigatran vs DOACScore

The dabigatran App is designed for doctors to help them manage patients on the anticoagulant dabigatran. It will be useful to general practitioners, cardiologists, haematologists, neurologists, anaesthetists, emergency specialists and surgeons. In fact most clinicians will at some time have patients on anticoagulants and would find this App helpful. The Dabigatran App will help you • Select the right treatment for your patient. • Provide safe advice if bleeding occurs including information about Idarucizumab • Recommend when to stop treatment before surgery. • Provide recommendations for managing emergency surgery • Interpret coagulation results. -------------------------------------------------------------------------- Features of the Dabigatran App Dose recommendation The Dabigatran App provides the correct dose for each indication with advice about possible dose changes in the presence of renal impairment Drug information Details of the common side-effects, potential drug interactions and basic pharmacology is immediately available. Managing bleeding Bleeding is a potential problem with any anticoagulant and can be complex to manage. The Dabigatran App provides advice about which treatments to use for both minor and major bleeding including when to use idarucizumab (Praxbind) Managing surgery A common question with any anticoagulant is how long should treatment be stopped before surgery? The Dabigatran App calculates a safe interval between stopping treatment and surgery by including renal function and the time since the last dose. It also offers advice for treatment prior to emergency surgery if the surgery cannot be delayed. Interpreting coagulation results Dabigatran prolongs several coagulation tests. The Dabigatran App combines the results of these tests to give an indication of the dabigtran plasma concentration. Referenced information All recommendations are linked to an information page which is appropriately referenced with links to the relevant publications. Website for feedback The Dabigatran App is linked to the Coagulation Conversation website to allow you to ask questions, provide feedback or even start a discussion. We welcome all feedback. ---------------------------------------------------------------- The advice is based on published reviews and guidelines. Extensive efforts have been made to ensure the accuracy of the information however information may change for specific countries at short notice. The user should refer to the manufacturers datasheet for complete prescribing information. Disclaimer This software is to be used as a guide only and healthcare professionals should use clinical judgement and should individualise care for each patient. In no event shall the author or developer be liable to any party for damages resulting from the use of this application.

This application is provided for the use of cardiologists and cardiac electrophysiologists, not the general public. If the user is not a cardiologist and wishes to use the app, then they should consult their cardiologist for further advice. The app does not provide any information regarding the dose or usage of direct acting anticoagulants. The DOAC score represents a significant scientific advance in anticoagulation management that balances the benefit of preventing stroke and systemic embolization with the risk of bleeding in patients with atrial fibrillation.The DOAC score allows the clinician to accurately quantify bleeding risk in patients taking DOACs while also helping identify bleeding risk factors and to correct those that are modifiable such as better controlling blood pressure, removing concomitant unnecessary antiplatelet or NSAID use, and counseling the patient about such factors. The bleeding risk assessment with the DOAC score and its clinical adoption improves patient care, highlight patients in whom risks are reversible, and provides caution when needed. The DOAC score could also potentially serve as a quantifiable measure with respect to selecting patients who might benefit from left atrial appendage closure and/or catheter ablation. The % one year bleeding risk is taken from development and validaiton cohorts and should only be considered a rough estimate. 1. Aggarwal R, Ruff CT, Virdone S, Perreault S, Kakkar AK, Palazzolo MG, et al. Development and Validation of the DOAC Score: A Novel Bleeding Risk Prediction Tool for Patients With Atrial Fibrillation on Direct-Acting Oral Anticoagulants. Circulation [Internet]. 2023 Sep 19 [cited 2025 Jan 14];148(12):936–46. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064556 2. Ezekowitz MD, Kamareddine M. Filling an Important Knowledge Gap: The DOAC Score. Circulation [Internet]. 2023 Sep 19 [cited 2025 Jan 15];148(12):947–9. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066316 3. Harano Y, Yamamoto M, Shimura T, Okubo M, Koyama Y, Yamaguchi R, et al. Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study. JAHA [Internet]. 2024 Nov 7 [cited 2024 Nov 15];e036417. Available from: https://www.ahajournals.org/doi/10.1161/JAHA.124.036417