Anticoagulation, Novel Agents, and Procedures: Can We "Pardon the Interruption?"
Circulation. 2012 Jun 14;
Authors: Garcia DA, Granger CB
When a patient with atrial fibrillation (AF) interrupts oral anticoagulation to undergo an invasive procedure, the clinician must answer two questions: for how long should the anticoagulant be stopped before the procedure, and should a "bridging" strategy be used with a shorter-acting agent? These questions are extremely important to the clinician who wants neither to use too much anticoagulation around procedures and cause unnecessary bleeding nor use too little and result in stroke. Based on decades of use of warfarin, the provider is left to choose an approach based on a subjective sense of the likely risks and benefits based on patient and procedural factors (Table 1). These decisions must be based on surprisingly little reliable evidence(1,2).(SELECT FULL TEXT TO CONTINUE).
PMID: 22700855 [PubMed - as supplied by publisher]