SVM-AVF Session: Anticoagulation in Special Populations
Anticoagulation in Obesity, Kidney, and Liver Disease
A pharmacology talk reviewed DOAC dosing evidence in patients with extreme obesity and after bariatric surgery, noting limited data above a BMI of 50 and variable drug absorption depending on surgical anatomy. A second talk addressed advanced kidney and liver disease, where both bleeding and clotting risk are elevated, and reviewed how hepatic and renal clearance differences among DOACs, along with drug interaction pathways, should guide anticoagulant selection in these patients.
Cancer-Associated Thrombosis and COVID-19
A third talk compared DOAC and low molecular weight heparin trial data for cancer-associated venous thromboembolism, highlighting lower recurrence with DOACs but increased gastrointestinal bleeding in certain cancer types. A closing talk reviewed COVID-19 associated thrombosis mechanisms and trial evidence across outpatient, hospitalized, and post-discharge settings, summarizing guideline-based prophylactic and therapeutic dosing recommendations for each stage of illness.
