Periprocedural management of direct oral anticoagulants in patients with atrial fibrillation and active cancer

Patients with active cancer were older (p < 0.001), more likely to be thrombocytopenic (p = 0.026), have moderate renal dysfunction (p = 0.005) and were more likely to receive lower-dose DOAC therapy (p < 0.001). A greater proportion of patients with active cancer underwent a high-bleed-risk procedure (p < 0.001), with longer periprocedural DOAC interruption intervals (p < 0.001) and lower preprocedural residual DOAC levels (p = 0.002). Active cancer was an independent predictor for surgical major bleeding (OR = 2.45; 95%CI 1.08-5.14) after adjusting for study center, procedure category and bleed risk, thrombocytopenia, hypertension, and the use of a P2Y12 inhibitor.