{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T19:01:44Z","timestamp":1784660504021,"version":"3.55.0"},"reference-count":63,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Hospitalized patients taking direct factor Xa inhibitors (DFXaIs), such as apixaban and rivaroxaban, often need to be transitioned to unfractionated heparin (UFH). This transition is complicated by residual DFXaI activity, which can lead to anticoagulant stacking and possible increased bleeding risk. The guidance on this transition from the manufacturers does not account for interpatient variability in drug clearance and may not be appropriate for all hospitalized patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Residual DFXaI anticoagulation at the time of UFH initiation can result in a period of dual anticoagulation or anticoagulant stacking. This issue is identified most often when heparin is monitored using the anti\u2013factor Xa assay as this assay is highly sensitive to the DFXaIs. Several retrospective descriptive studies have reported supratherapeutic heparin levels (above 0.7 units\/mL), which can last for days depending on the presence of patient-specific factors that reduce DFXaI clearance. The period of anticoagulant stacking has been associated with bleeding events. With the UFH anti\u2013factor Xa assay detecting both anticoagulants, alternative methods are needed for heparin monitoring when transitioning from a DFXaI to UFH. Limited data describe alternative approaches that can be categorized as approaches that ignore residual DFXaI anticoagulation and ones that account for residual DFXaI anticoagulation. Observational data suggest that approaches that measure baseline residual DFXaI anticoagulation allow for a delay in UFH initiation and can reduce bleeding risk. The authors provide recommendations for hospitals or health systems to consider for optimizing management of the transition from DFXaI to UFH therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Each hospital or health system should develop a structured approach for managing DFXaI to UFH transitions. Ideally, the transition should be managed by pharmacists and involve measurement of residual DFXaI anticoagulation to inform the timing of UFH initiation. Prospective studies are needed to better define best practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxag202","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:49:11Z","timestamp":1783082951000},"source":"Crossref","is-referenced-by-count":0,"title":["Optimizing transitions from direct factor Xa inhibitors to unfractionated heparin therapy"],"prefix":"10.1093","author":[{"given":"Michael P","family":"Gulseth","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Services, Sanford USD Medical Center , Sioux Falls, SD , , Sioux Falls, SD ,","place":["USA"]},{"name":"and Department of Internal Medicine, University of South Dakota Sanford School of Medicine , Sioux Falls, SD , , Sioux Falls, SD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Dinunno","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Houston Methodist Hospital , Houston, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc D","family":"Smith","sequence":"additional","affiliation":[{"name":"Corewell Health East Coagulation Laboratories, Corewell Health, William Beaumont University Hospital , Royal Oak, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen A","family":"Smythe","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"issue":"2","key":"2026072114263702400_zxag202-B1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.chest.2024.03.003","article-title":"Antithrombotic therapy for VTE disease: compendium and review of CHEST guidelines 2012-2021","volume":"166","author":"Stevens","year":"2024","journal-title":"Chest"},{"issue":"1","key":"2026072114263702400_zxag202-B2","first-page":"e1","article-title":"ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2023","journal-title":"Circulation"},{"issue":"3","key":"2026072114263702400_zxag202-B3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s40256-024-00638-4","article-title":"Trends in oral anticoagulant use and individual expenditures across the United States from 2014 to 2020","volume":"24","author":"Alkhezi","year":"2024","journal-title":"Am J Cardiovasc Drugs"},{"issue":"1","key":"2026072114263702400_zxag202-B4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12959-025-00703-1","article-title":"Evaluation of direct oral anticoagulant continuation versus switching to a parenteral anticoagulant in critically ill patients: a retrospective cohort study","volume":"23","author":"Alshehri","year":"2025","journal-title":"Thromb J"},{"issue":"24","key":"2026072114263702400_zxag202-B5","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.2146\/ajhp150596","article-title":"Managing transitions from oral factor Xa inhibitors to unfractionated heparin infusions","volume":"73","author":"Faust","year":"2016","journal-title":"Am J Health-Syst Pharm"},{"issue":"2","key":"2026072114263702400_zxag202-B6","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/1060028017729481","article-title":"Influence of direct oral anticoagulants on anti-factor Xa measurements utilized for monitoring heparin","volume":"52","author":"Macedo","year":"2018","journal-title":"Ann Pharmacother"},{"issue":"6","key":"2026072114263702400_zxag202-B7","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1016\/j.jtha.2025.02.026","article-title":"How to deal with interference on heparin anti-Xa activity caused by oral factor FXa inhibitors: communication from the ISTH SSC Subcommittee on Control of Anticoagulation","volume":"23","author":"Gendron","year":"2025","journal-title":"J Thromb Haemost"},{"issue":"5","key":"2026072114263702400_zxag202-B8","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1097\/FTD.0000000000000774","article-title":"Perils of antithrombotic transitions: effect of oral factor Xa inhibitors on the heparin antifactor Xa assay","volume":"42","author":"Ahuja","year":"2020","journal-title":"Ther Drug Monit"},{"key":"2026072114263702400_zxag202-B9","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12959-015-0037-1","article-title":"Global assays and the management of oral anticoagulation","volume":"13","author":"Brinkman","year":"2015","journal-title":"Thromb J"},{"key":"2026072114263702400_zxag202-B10","volume-title":"Interference Testing in Clinical Chemistry","author":"Clinical & Laboratory Standards Institute","year":"2018","edition":"3rd ed"},{"issue":"2","key":"2026072114263702400_zxag202-B11","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ahj.2009.05.022","article-title":"Adding intravenous unfractionated heparin to standard enoxaparin causes excessive anticoagulation not detected by activated clotting time: results of the Stack-on to Enoxaparin (STACKENOX) study","volume":"158","author":"Drouet","year":"2009","journal-title":"Am Heart J"},{"issue":"10","key":"2026072114263702400_zxag202-B12","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s40262-019-00775-z","article-title":"Apixaban: a clinical pharmacokinetic and pharmacodynamic review","volume":"58","author":"Byon","year":"2019","journal-title":"Clin Pharmacokinet"},{"issue":"5","key":"2026072114263702400_zxag202-B13","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1111\/bcp.12106","article-title":"Safety, pharmacokinetics and pharmacodynamics of multiple oral doses of apixaban, a factor Xa inhibitor, in healthy subjects","volume":"76","author":"Frost","year":"2013","journal-title":"Br J Clin Pharmacol"},{"issue":"1","key":"2026072114263702400_zxag202-B14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40262-013-0100-7","article-title":"Clinical pharmacokinetic and pharmacodynamic profile of rivaroxaban","volume":"53","author":"Mueck","year":"2014","journal-title":"Clin Pharmacokinet"},{"issue":"7","key":"2026072114263702400_zxag202-B15","doi-asserted-by":"crossref","first-page":"549","DOI":"10.5414\/CP201812","article-title":"The effect of food on the absorption and pharmacokinetics of rivaroxaban","volume":"51","author":"Stampfuss","year":"2013","journal-title":"Int J Clin Pharmacol Ther"},{"issue":"2","key":"2026072114263702400_zxag202-B16","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1177\/0091270006296058","article-title":"Body weight has limited influence on the safety, tolerability, pharmacokinetics, or pharmacodynamics of rivaroxaban (BAY 59-7939) in healthy subjects","volume":"47","author":"Kubitza","year":"2007","journal-title":"J Clin Pharmacol"},{"issue":"12","key":"2026072114263702400_zxag202-B17","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s00228-005-0043-5","article-title":"Safety, pharmacodynamics, and pharmacokinetics of BAY 59-7939\u2014an oral, direct factor Xa inhibitor\u2014after multiple dosing in healthy male subjects","volume":"61","author":"Kubitza","year":"2005","journal-title":"Eur J Clin Pharmacol"},{"issue":"1","key":"2026072114263702400_zxag202-B18","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1124\/dmd.108.023143","article-title":"Apixaban metabolism and pharmacokinetics after oral administration to humans","volume":"37","author":"Raghavan","year":"2009","journal-title":"Drug Metab Dispos"},{"issue":"5","key":"2026072114263702400_zxag202-B19","doi-asserted-by":"crossref","first-page":"285","DOI":"10.2165\/00003088-200847050-00001","article-title":"Clinical pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor dabigatran etexilate","volume":"47","author":"Stangier","year":"2008","journal-title":"Clin Pharmacokinet"},{"issue":"2","key":"2026072114263702400_zxag202-B20","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/jth.13912","article-title":"Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians","volume":"16","author":"Douxfils","year":"2018","journal-title":"J Thromb Haemost"},{"issue":"8","key":"2026072114263702400_zxag202-B21","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1055\/a-1450-8178","article-title":"update of the International Council for Standardization in Haematology recommendations for laboratory measurement of direct oral anticoagulants","volume":"121","author":"Douxfils","year":"2021","journal-title":"Thromb Haemost"},{"issue":"8","key":"2026072114263702400_zxag202-B22","first-page":"1036","article-title":"Interpatient variation in rivaroxaban and apixaban plasma concentrations in routine care","volume":"33","author":"Gulilat","year":"2017","journal-title":"Can J Cardiol"},{"issue":"10","key":"2026072114263702400_zxag202-B23","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2165\/11595320-000000000-00000","article-title":"Rivaroxaban: population pharmacokinetic analyses in patients treated for acute deep-vein thrombosis and exposure simulations in patients with atrial fibrillation treated for stroke prevention","volume":"50","author":"Mueck","year":"2011","journal-title":"Clin Pharmacokinet"},{"issue":"4","key":"2026072114263702400_zxag202-B24","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jacc.2013.07.104","article-title":"The effect of dabigatran plasma concentrations and patient characteristics on the frequency of ischemic stroke and major bleeding in atrial fibrillation patients: the RE-LY trial (randomized evaluation of long-term anticoagulation therapy)","volume":"63","author":"Reilly","year":"2014","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2026072114263702400_zxag202-B25","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1001\/jamacardio.2017.0364","article-title":"Laboratory monitoring of non-vitamin K antagonist oral anticoagulant use in patients with atrial fibrillation: a review","volume":"2","author":"Eikelboom","year":"2017","journal-title":"JAMA Cardiol"},{"key":"2026072114263702400_zxag202-B26"},{"key":"2026072114263702400_zxag202-B27"},{"issue":"suppl 3","key":"2026072114263702400_zxag202-B28","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1093\/ajhp\/zxaa143","article-title":"Transitioning hospitalized patients from rivaroxaban or apixaban to a continuous unfractionated heparin infusion: a retrospective review","volume":"77","author":"Smith","year":"2020","journal-title":"Am J Health-Syst Pharm"},{"issue":"12","key":"2026072114263702400_zxag202-B29","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1177\/10600280221090211","article-title":"Comparison of managing factor Xa inhibitor to unfractionated heparin transitions by aPTT versus a treatment guideline utilizing heparin anti-Xa levels","volume":"56","author":"Dingus","year":"2022","journal-title":"Ann Pharmacother"},{"issue":"10","key":"2026072114263702400_zxag202-B30","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1002\/phar.2726","article-title":"Direct oral to parenteral anticoagulant transitions: role of factor Xa inhibitor-specific anti-Xa concentrations","volume":"42","author":"Dinunno","year":"2022","journal-title":"Pharmacotherapy"},{"issue":"4","key":"2026072114263702400_zxag202-B31","doi-asserted-by":"crossref","first-page":"85155","DOI":"10.56305\/001c.85155","article-title":"When apixaban and rivaroxaban interfere with anti-Xa assays: a cohort study","volume":"2","author":"El Hasbani","year":"2023","journal-title":"J Brown Hosp Med"},{"issue":"5","key":"2026072114263702400_zxag202-B32","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/ijlh.12528","article-title":"Comparison of the effect of the anti-Xa direct oral anticoagulants apixaban, edoxaban, and rivaroxaban on coagulation assays","volume":"38","author":"Gosselin","year":"2016","journal-title":"Int J Lab Hematol"},{"issue":"11","key":"2026072114263702400_zxag202-B33","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1016\/j.jacc.2014.05.065","article-title":"Laboratory measurement of the anticoagulant activity of the non-vitamin K oral anticoagulants","volume":"64","author":"Cuker","year":"2014","journal-title":"J Am Coll Cardiol"},{"issue":"3","key":"2026072114263702400_zxag202-B34","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1055\/s-0038-1627480","article-title":"International Council for Standardization in Haematology (ICSH) recommendations for laboratory measurement of direct oral anticoagulants","volume":"118","author":"Gosselin","year":"2018","journal-title":"Thromb Haemost"},{"issue":"1","key":"2026072114263702400_zxag202-B35","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1182\/hematology.2019000027","article-title":"Direct oral anticoagulant monitoring: what laboratory tests are available to guide us?","volume":"2019","author":"Sarode","year":"2019","journal-title":"Hematology"},{"issue":"1","key":"2026072114263702400_zxag202-B36","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11239-015-1315-2","article-title":"Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism","volume":"41","author":"Smythe","year":"2016","journal-title":"J Thromb Thrombolysis"},{"issue":"5","key":"2026072114263702400_zxag202-B37","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/1076029616629759","article-title":"Evaluation of a heparin-calibrated antifactor Xa assay for measuring the anticoagulant effect of oral direct Xa inhibitors","volume":"22","author":"Beyer","year":"2016","journal-title":"Clin Appl Thromb Hemost"},{"issue":"5","key":"2026072114263702400_zxag202-B38","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.pathol.2022.01.004","article-title":"Prospective cohort study on the use of low molecular weight heparin calibrated anti-Xa assay for measurement of direct oral Xa inhibitors in ex vivo patient samples","volume":"54","author":"Lim","year":"2022","journal-title":"Pathology"},{"issue":"3","key":"2026072114263702400_zxag202-B39","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.cll.2024.04.014","article-title":"Assessing direct oral anticoagulants in the clinical laboratory","volume":"44","author":"Gosselin","year":"2024","journal-title":"Clin Lab Med"},{"issue":"11","key":"2026072114263702400_zxag202-B40","doi-asserted-by":"crossref","first-page":"2494","DOI":"10.1111\/jth.15884","article-title":"The myths behind DOAC measurement: analyses of prescribing information from different regulatory bodies and a call for harmonization","volume":"20","author":"Gosselin","year":"2022","journal-title":"J Thromb Haemost"},{"issue":"1","key":"2026072114263702400_zxag202-B41","doi-asserted-by":"crossref","first-page":"126","DOI":"10.5853\/jos.2022.03034","article-title":"Practical nomogram predicting apixaban or rivaroxaban concentrations from low-molecular-weight heparin anti-Xa values: special interest in acute ischemic stroke patients","volume":"25","author":"Brakta","year":"2023","journal-title":"J Stroke"},{"issue":"6","key":"2026072114263702400_zxag202-B42","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1111\/bjh.17470","article-title":"A universal anti-Xa assay for rivaroxaban, apixaban, and edoxaban measurements: method validation, diagnostic accuracy and external validation","volume":"193","author":"Willekens","year":"2021","journal-title":"Br J Haematol"},{"key":"2026072114263702400_zxag202-B43","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.thromres.2017.05.024","article-title":"Heparin-calibrated chromogenic anti-Xa assays are not suitable to assess the presence of significant direct factor Xa inhibitors levels","volume":"156","author":"Sabor","year":"2017","journal-title":"Thromb Res"},{"key":"2026072114263702400_zxag202-B44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.thromres.2022.05.005","article-title":"Low molecular weight heparin anti-Xa assays can identify patients with clinically important apixaban and rivaroxaban drug levels","volume":"215","author":"Mithoowani","year":"2022","journal-title":"Thromb Res"},{"issue":"4","key":"2026072114263702400_zxag202-B45","first-page":"723","article-title":"Comparison of calibrated chromogenic anti-Xa assay and PT tests with LC-MS\/MS for the therapeutic monitoring of patients treated with rivaroxaban","volume":"110","author":"Douxfils","year":"2013","journal-title":"Thromb Haemost"},{"issue":"6","key":"2026072114263702400_zxag202-B46","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1055\/s-0032-1319770","article-title":"Unfractionated heparin for the treatment of venous thromboembolism: best practices and areas of uncertainty","volume":"38","author":"Cuker","year":"2012","journal-title":"Semin Thromb Hemost"},{"issue":"6","key":"2026072114263702400_zxag202-B47","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1002\/j.1875-9114.2011.01049.x","article-title":"Antifactor Xa levels versus activated partial thromboplastin time for monitoring unfractionated heparin","volume":"32","author":"Vandiver","year":"2012","journal-title":"Pharmacotherapy"},{"issue":"9","key":"2026072114263702400_zxag202-B48","doi-asserted-by":"publisher","DOI":"10.7754\/Clin.Lab.2024.240314","article-title":"Heparin-calibrated anti-factor Xa assay for the measurement of direct anticoagulants such as apixaban, rivaroxaban, and edoxaban","volume":"70","author":"Ahn","year":"2024","journal-title":"Clin Lab"},{"issue":"5","key":"2026072114263702400_zxag202-B49","doi-asserted-by":"crossref","first-page":"E132","DOI":"10.1002\/ajh.25434","article-title":"Using an old test for new tricks: measuring direct oral anti-Xa drug levels by conventional heparin-calibrated anti-Xa assay","volume":"94","author":"Maier","year":"2019","journal-title":"Am J Hematol"},{"issue":"7","key":"2026072114263702400_zxag202-B50","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1177\/1060028015578451","article-title":"Heparin-calibrated chromogenic anti-Xa activity measurements in patients receiving rivaroxaban: can this test be used to quantify drug level?","volume":"49","author":"Gosselin","year":"2015","journal-title":"Ann Pharmacother"},{"issue":"8","key":"2026072114263702400_zxag202-B51","doi-asserted-by":"crossref","first-page":"563","DOI":"10.2146\/ajhp150360","article-title":"Influence of apixaban on antifactor Xa levels in a patient with acute kidney injury","volume":"73","author":"Wendte","year":"2016","journal-title":"Am J Health-Syst Pharm"},{"issue":"3","key":"2026072114263702400_zxag202-B52","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1093\/ajcp\/aqab135","article-title":"From activated partial thromboplastin time to antifactor Xa and back again","volume":"157","author":"May","year":"2022","journal-title":"Am J Clin Pathol"},{"issue":"7","key":"2026072114263702400_zxag202-B53","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1111\/jth.14806","article-title":"Anti-factor IIa (FIIa) heparin assay for patients on direct factor Xa (FXa) inhibitors","volume":"18","author":"Stuart","year":"2020","journal-title":"J Thromb Haemost"},{"key":"2026072114263702400_zxag202-B54","first-page":"e24S","volume-title":"Chest","author":"Garcia","year":"2012","edition":"9th ed"},{"issue":"5","key":"2026072114263702400_zxag202-B55","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1177\/1060028020956271","article-title":"A systemwide approach for navigating the dilemma of oral factor Xa inhibitor interference with unfractionated heparin anti-factor Xa concentrations","volume":"55","author":"Levito","year":"2021","journal-title":"Ann Pharmacother"},{"issue":"9","key":"2026072114263702400_zxag202-B56","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1002\/phar.2444","article-title":"The relationship between the initial anti-factor Xa measurement and the duration of direct oral anticoagulant influence in patients transitioning to heparin","volume":"40","author":"Plum","year":"2020","journal-title":"Pharmacotherapy"},{"issue":"2","key":"2026072114263702400_zxag202-B57","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1093\/jalm\/jfaa084","article-title":"A novel laboratory assay to monitor unfractionated heparin dosing in patients taking apixaban prior to hospital admission","volume":"6","author":"Strickland","year":"2021","journal-title":"J Appl Lab Med"},{"issue":"8","key":"2026072114263702400_zxag202-B58","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/ajhp\/zxz013","article-title":"Use of specific anti-Xa levels in acute kidney injury to transition patients from oral factor Xa inhibitors to i.v. heparin infusion","volume":"76","author":"Zochert","year":"2019","journal-title":"Am J Health-Syst Pharm"},{"issue":"2","key":"2026072114263702400_zxag202-B59","doi-asserted-by":"crossref","first-page":"e2458742","DOI":"10.1001\/jamanetworkopen.2024.58742","article-title":"Perioperative factor Xa inhibitor discontinuation for patients undergoing procedures with minimal or low bleeding risk","volume":"8","author":"Lee","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"5","key":"2026072114263702400_zxag202-B60","doi-asserted-by":"crossref","first-page":"e207","DOI":"10.1016\/j.chest.2022.07.025","article-title":"Perioperative management of antithrombotic therapy: an American College of Chest Physicians clinical practice guideline","volume":"162","author":"Douketis","year":"2022","journal-title":"Chest"},{"issue":"11","key":"2026072114263702400_zxag202-B61","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1001\/jamainternmed.2019.2431","article-title":"Perioperative management of patients with atrial fibrillation receiving a direct oral anticoagulant","volume":"179","author":"Douketis","year":"2019","journal-title":"JAMA Intern Med"},{"issue":"13","key":"2026072114263702400_zxag202-B62","first-page":"e771","article-title":"ACC\/AHA\/ACEP\/NAEMSP\/SCAI guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"151","author":"Rao","year":"2025","journal-title":"Circulation"},{"key":"2026072114263702400_zxag202-B63","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.amjcard.2023.07.092","article-title":"Direct oral anticoagulants affect activated clotting time during and bleeding events after percutaneous coronary intervention","volume":"204","author":"Shibahashi","year":"2023","journal-title":"Am J Cardiol"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxag202\/68696312\/zxag202.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxag202\/68696312\/zxag202.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:26:50Z","timestamp":1784658410000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article\/doi\/10.1093\/ajhp\/zxag202\/8724785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,4]]},"references-count":63,"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxag202","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,4]]},"article-number":"zxag202"}}