Comparison of temporary interruption with continuation of direct oral anticoagulants for low bleeding risk procedures.
Bleeding
Direct oral anticoagulants
Low bleeding risk procedures
Thromboembolism
Journal
Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
15
02
2021
revised:
11
04
2021
accepted:
12
04
2021
pubmed:
28
4
2021
medline:
29
6
2021
entrez:
27
4
2021
Statut:
ppublish
Résumé
Limited data is available on the rates of bleeding and thromboembolic events for patients undergoing low bleeding risk procedures while taking direct oral anticoagulants (DOAC). Adults taking DOAC in the Michigan Anticoagulation Quality Improvement Initiative (MAQI There were 820 patients who underwent 1412 low risk procedures. DOAC therapy was temporarily interrupted in 371 (45.2%) patients (601 [42.6%] procedures) and continued uninterrupted in 449 (54.8%) patients (811 [57.4%] procedures). DOAC patients with temporary interruptions were more likely to have diabetes, prior stroke or TIA, prior bleeding, higher CHA2DS2-VASc, and higher modified HAS-BLED scores. DOAC interruption was common for gastrointestinal endoscopy, electrophysiology device implantation, and cardiac catheterization while it was less common for cardioversion, dermatologic procedures, and subcutaneous injection. After propensity score adjustment, bleeding risk was lower in the DOAC temporary interruption group (OR 0.62, 95% CI 0.41-0.95) as compared to the group with continuous DOAC use. Rates of thromboembolic events and death did not differ significantly between the two groups. DOAC-treated patients undergoing low bleeding risk procedures may experience lower rates of bleeding when DOAC is temporarily interrupted. Prospective studies focused on low bleeding risk procedures are needed to identify the safety DOAC management strategy.
Identifiants
pubmed: 33906063
pii: S0049-3848(21)00291-7
doi: 10.1016/j.thromres.2021.04.006
pmc: PMC8225570
mid: NIHMS1695310
pii:
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
27-32Subventions
Organisme : NHLBI NIH HHS
ID : K01 HL135392
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.
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