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Hi everyone, this is John Mandrola from the Heart.org Medscape Cardiology and this is this week in

Cardiology for November 15th 2019

This week in a coagulation interruption for surgery, marijuana, an orbita sub-study,

eschemia trial baseline characteristics, and a bit more AHAha preview. First off I want to apologize for my voice. I have a killer

virus that's attacked my vocal cords. First topic is the increased use of doax have changed decision-making about the interruption of oral

anti-coagulation at the time of surgery. In the days of warfarin, we had to stop warfarin many days before and if the patient was high risk bridge with heparin.

The warfarin is tricky because of its inconsistent and variable pharmacokinetics.

Doax have a much more predictable pharmacokinetics and the idea is that you could stop the drugs

one or two days before and minimize the time of being

unprotected.

Jama Internal Medicine recently published a large cohort study that came from multiple

centers but it was led by the McMaster's group and they

investigated the safety of a standardized perioperative Doha management strategy.

Their acronym is called P-A-U-S-E in the study enrolled greater than 3,000 patients who are scheduled for surgery from centers in the U.S, Canada, and Europe.

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