When patients on oral anticoagulants (OACs) undergo unplanned coronary interventions, should they put OAC therapy on hold until after the procedure? A research team out of Sweden hoped to answer that very question, sharing its findings in JACC: Cardiovascular Interventions.
The group began its analysis by exploring the benefits of both interrupted oral anticoagulant therapy (I-OAC) and uninterrupted oral anticoagulant therapy (U-OAC).
“U-OAC during percutaneous coronary intervention (PCI) may increase the risk for peri-procedural bleeds, especially in patients receiving dual antiplatelet therapy and unfractionated heparin,” wrote lead author Dimitrios Venetsanos, MD, PhD, a cardiologist at Karolinska University Hospital in Sweden, and colleagues. “On the other hand, temporary interruption of OAC may increase the risk for thromboembolic complications and delay PCI, which may increase the risk for ischemic complications. Moreover, a strategy with interruption of OAC may increase time to intervention and prolong hospital stay.”
The group focused on information taken from the SWEDEHEART registry, including data from more than 6,000 patients who underwent either underwent PCI or coronary angiography from 2005 to 2017. All patients were already on OAC therapy at the time of the procedure. While more than 51% of the cohort was treated with I-OAC, the remaining patients were treated with uninterrupted oral anticoagulant therapy U-OAC.
Overall, the risk of a major adverse cardiac and cerebrovascular event such as death, myocardial infarction or stroke was similar between the two groups. However, a U-OAC strategy was associated with shorter lengths of stay at the hospital, a statistic that translates to significant cost savings over time. U-OAC is also a “simpler strategy,” the team added.
“Our results support the current recommendation by the European Society of Cardiology guidelines advocating U-OAC as the preferred peri-procedural antithrombotic strategy,” the authors concluded.
Read the full evaluation here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.