Would you consider using DOACs as a bridge to warfarin instead of heparin or LMWH?

I would feel very comfortable bridging with apixaban, given its relatively short half-life and fairly quick absorption. I think it is very similar to bridging with Lovenox.

More importantly, it usually takes at least 24 hours until heparin IV gets to therapeutic levels - it is often too high or too ...

This is an interesting question. My bias would be to bridge back to warfarin under cover of IV unfractionated heparin. Each DOAC has a different elimination route with approximate renal elimination as follows: dabigatran: 80%; edoxaban: 50%; rivaroxaban: 33%; apixaban: 25% (Baker et al., PMID 392236...

After 3 months of anticoagulation for APSy, the estimated annual risk of VTE recurrence is about 5% max; this converts into ~0.01% risk/day. On the other hand, the serious bleeding risk with bridging is about 1-2% per day in patients with ESRD/HD (even in the setting of mechanical valve, the estimat...