Also consider increased risk of bleeding  High risk of bleeding (HAS-BLED $ 3). Consider agent with the lowest bleeding risk  Once-daily dosing or preference to have lower pill burden E R VKA c  Asian patients. Consider agents with reduced risk of ICH and major bleed in Asian populations  Less likely to do well on VKA (SAMe-TT2R2 score > 2). Avoid any potential trial of VKA if possible NOAC preferred (A D E R) . 146, 179, 183 VKA with additional education, more regular follow-up, and frequent INR checks A apixaban; CrCl creatinine clearance; D dabigatran; E edoxaban; R rivaroxaban; TIA transient ischemic attack. See Table 1 and 2 legends for expansion of other abbreviations. a Reduced to 2.5 mg bid with two of three criteria from age $ 80 years, body weight # 60 kg, or serum creatinine concentration $ 133 mmol/L. b 110 mg bid for patients with a CrCl 30 to 49 mL/min (most countries, but not in the United States); in the United States only, 75 mg bid (available in the United States only) for patients with CrCl 15 to 29 mL/min (and only 150 mg bid dose available in the United States for CrCl > 30 mL/min). c Not available. d Dose to be halved if the patient has any of the following: CrCl 15 to 49 mL/min, body weight # 60 kg, or concomitant use of P-glycoprotein inhibitors. chestjournal.org attenuate bleeding across the NOACs.207,213-219 The limited data in humans are restricted to healthy volunteers. In 3 small (12-93 patients) randomized, placebo-controlled studies, PCC reversed the anticoagulant effect of rivaroxaban and edoxaban but There was a dose-dependent relationship with complete reversal with 50 U/kg and partial reversal with 25 U/kg. 