Direct Oral Anticoagulants (DOACs) have transformed modern anticoagulation by providing predictable, safe, and convenient alternatives to warfarin for stroke prevention, VTE management, and thromboembolic risk reduction in cardiovascular disease. This session provides a comprehensive exploration of pharmacology, dosing strategies, clinical applications, bleeding risk mitigation, and management of special populations. As clinicians increasingly search for a focused cardiology conference, this session equips participants with a deep understanding of drug selection, monitoring principles, and evidence-based decision-making.

The description highlights the four major DOACs—apixaban, rivaroxaban, dabigatran, and edoxaban—and compares mechanisms involving factor Xa and direct thrombin inhibition. Participants will examine pharmacokinetics, food interactions, renal clearance, drug–drug interactions, and reversal agents such as andexanet alfa and idarucizumab. The session explains how DOACs simplify anticoagulation by eliminating routine INR monitoring, while emphasizing circumstances where monitoring or dose adjustments are necessary.

A major focus is implementing advanced DOAC management strategies in atrial fibrillation, VTE treatment, extended prophylaxis, peri-procedural planning, cardioversion, and structural heart interventions. The session describes dosing nuances based on kidney function, body weight, age, bleeding risk, and concomitant therapies. Participants will learn practical frameworks for managing bleeding emergencies, bridging decisions, and perioperative interruption.

The content also addresses challenging populations—elderly patients, those with CKD, liver disease, malignancy, thrombophilia, and patients requiring dual antiplatelet therapy. Real-world cases explain how to balance ischemic and bleeding risks in AF with coronary stents, post-TAVR patients, and individuals undergoing complex PCI.

Future topics include DOAC use in LV thrombus, emerging agents with extended half-lives, improved reversal therapies, and personalized anticoagulation based on genomics and AI-based risk predictors. By the end of the session, clinicians will feel confident prescribing and managing DOACs in diverse scenarios.