DOACs and Intracranial Hemorrhage:
Best Practices to Optimize Outcomes

Symposium and Lunch: 12:15-1:15 PM CT
Venue: Phoenix Convention Center
Ballroom: Room West 106ABC
100 N 3rd Street, Phoenix, Arizona


Chair: Joshua Goldstein, MD, PhD

Faculty: Anne Alexandrov, PhD, AGACNP-BC, ANVP-BC, NVRN-BC, ASC-BC; Casey May, PharmD, BCCCP; Ashkan Shoamanesh, MD

Registration for this program is now closed.

Direct oral anticoagulants (DOACs) have become widely used for the prevention and treatment of venous thromboembolism, stroke prevention in atrial fibrillation, and management of patients with coronary artery disease or peripheral artery disease. Large clinical trials have demonstrated that DOACs are as effective and safer than warfarin and are now widely recommended by guidelines. Despite their superior safety, a small percentage of patients suffer intracranial hemorrhage, which is associated with 30-day mortality rates approaching 50%. Specific agents that reverse anticoagulation with factor Xa inhibition and with oral direct thrombin inhibition have demonstrated effectiveness in clinical trials and are now preferred therapies in guidelines and statements from the American Heart Association/American Stroke Association (endorsed by multiple societies including the Neurocritical Care Society) and the American College of Cardiology Expert Consensus Decision Pathway. There is a lack of clinician awareness of prudent initial interventions for intracranial hemorrhage, clinical profiles of reversal agents, and guideline recommendations for reversal of anticoagulants. Intracranial hemorrhage is a complex clinical event that has been shown to benefit from specially trained, multidisciplinary care; a multidisciplinary team is recommended in clinical practice guidelines to improve outcomes and reduce mortality. Therefore, in this program, Program Chair Dr. Joshua Goldstein and an expert multidisciplinary faculty (Dr. Casey May, Dr. Anne Alexandrov, and Dr. Ashkan Shoamanesh) will provide attendees with best practices for optimal management of intracranial hemorrhage.

Educational Objectives: 

1. Interpret clinical evidence with specific DOAC reversal agents in patients experiencing intracranial hemorrhage.
2. Recognize guideline recommendations for the use of DOAC reversal agents in intracranial hemorrhage patients
3. Describe the roles of multispecialty team members in managing patients taking DOACs who are experiencing intracranial hemorrhage

Accreditation & Credit Designation:
Voxmedia LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Voxmedia LLC designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners may participate in this educational activity and earn a certificate of completion as AANP accepts AMA PRA Category 1 Credits^TM through its reciprocity agreements.

The National Commission on Certification of Physician Assistants accepts AMA PRA Category 1 Credits ^TM from organizations accredited by the ACCME.

Educational Grant: Voxmedia International gratefully acknowledges the educational grant from AstraZeneca Pharmaceuticals.

Target Audience:  This educational activity is intended for clinicians managing patients experiencing intracranial hemorrhage.