Perioperative bridging anticoagulation during dabigatran or warfarin interruption among patients who had an elective surgery or procedure Substudy of the RE-LY trial
Perioperative bridging anticoagulation during dabigatran or warfarin interruption among patients who had an elective surgery or procedure Substudy of the RE-LY trial
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DOI：
10.1160/th14-04-0305
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发表时间：
2015-03-01
影响因子：
6.7
通讯作者：
Connolly, Stuart J.
中科院分区：
文献类型：
--
作者：
Douketis, James D.;Healey, Jeff S.;Connolly, Stuart J.
房颤（AF）患者在择期手术/程序中需要中断达比加群或华法林治疗，围手术期桥接抗凝治疗的风险和益处尚不确定。我们访问了RE-LY的数据库，这是一项比较达比加群与华法林预防房颤卒中的随机试验，以评估桥接的潜在益处和风险。在选择性手术/程序中首次中断达比加群或华法林的患者中，我们比较了在手术/程序前7天至手术/程序后30天内桥接或未桥接的患者发生大出血（MB）、中风或全身性栓塞（SSE）和任何血栓栓塞（TE）的风险。我们使用多变量Cox回归来调整潜在的混杂因素。华法林中断期间桥接的使用比达比加群中断期间更多(27.5% vs 15.4%; p
In patients with atrial fibrillation (AF) who require interruption of dabigatran or warfarin for an elective surgery/procedure, the risks and benefits of perioperative bridging anticoagulation is uncertain. We accessed the database from RE-LY, a randomised trial comparing dabigatran with warfarin for stroke prevention in AF, to assess the potential benefits and risks of bridging. In patients who had a first interruption of dabigatran or warfarin for an elective surgery/procedure, we compared the risk for major bleeding (MB), stroke or systemic embolism (SSE) and any thromboembolism (TE) in patients who were bridged or not bridged during the period of seven days before until 30 days after surgery/procedure. We used multivariable Cox regression to adjust for potential confounders. Bridging was used more during warfarin interruption than dabigatran interruption (27.5% vs 15.4%; p