Question

A 52-year-old woman with nonvalvular AF (CHA₂DS₂‑VASc 1 for hypertension) will undergo colonoscopy with polypectomy (high bleeding risk). She is on warfarin with therapeutic INRs. Optimal bridging strategy?

Accepted Answer

Stop warfarin 5 days prior without bridging, then resume <24 hours after

Answer

Stop warfarin and bridge with therapeutic-dose LMWH

Answer

Continue warfarin through the procedure

Answer

Switch temporarily to a DOAC

Answer

Bridge with IV heparin infusion

Practice question

A 52-year-old woman with nonvalvular AF (CHA₂DS₂‑VASc 1 for hypertension) will undergo colonoscopy with polypectomy (high bleeding risk). She is on warfarin with therapeutic INRs. Optimal bridging strategy?