ALB and Hypoalbuminemia: In general, DOAC binds to serum albumin at a certain level in the bloodstream and transitions between bound and unbound forms according to the dissociation equilibrium constant.4,5 The unbound free form of the drug is known to be responsible for its therapeutic effect.6,7 Therefore, the reduction of albumin will increase free drug concentrations, enhancing the drug's effect.8 However, hypoalbuminemia has not been well investigated as a bleeding risk factor for patients on DOAC.