Interruption of all anticoagulation is non-inferior to the use of short-term parenteral bridging in patients with atrial fibrillation undergoing invasive procedures

Commentary on: Douketis JD, Spyropoulos AC, Kaatz S, et al., BRIDGE Investigators. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med 2015;373:823–33 . Context Oral anticoagulation (OAC) has been demonstrated to reduce stroke in patients with atrial fibrillation (AF), however, its use conveys an increased risk of bleeding.1 Therefore, patients receiving OAC who undergo invasive procedures often ‘interrupt’ OAC. Use of short-term ‘bridging’ anticoagulants during such interruptions has been the source of significant debate.2 Although guidelines support a risk-based approach, there is little randomised data to support this.3 Observational data have suggested increased harm and minimal benefit associated with bridging,4 yet until now there have been insufficient prospective randomised data. Methods This trial was a prospective, multicentre, randomised, placebo-controlled trial. The investigators sought to determine the necessity of short-term bridging anticoagulation in patients with AF...
Source: Evidence-Based Medicine - Category: Internal Medicine Authors: Tags: Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Valvar diseases, Arrhythmias Therapeutics/Prevention Source Type: research