Periprocedural Anticoagulation Management of Patients receiving Warfarin in Qatar: A Prospective Cohort Study

Curr Probl Cardiol. 2021 Jun;46(6):100816. doi: 10.1016/j.cpcardiol.2021.100816. Epub 2021 Feb 15.

Abstract

Background: The use of anticoagulant bridging remains controversial. This study was conducted to evaluate our warfarin periprocedural management in Qatar and investigate the associated clinical outcomes with such management.

Methods: A prospective cohort study was designed to describe the periprocedural clinical practice in warfarin patients in Qatar and to compare clinical safety and efficacy outcomes between anticoagulant bridging and nonbridging.

Results: 103 patients were recruited. Bridging occurred in 82% of the participants. No thromboembolic events were observed, while 39.1% of patients experienced bleeding events during the study period. The incidence of overall bleeding and major bleeding were numerically higher for bridging group compared to nonbridging but did not reach statistical significance ([30.6% vs 22.2%, P = 0.478] and [12.9% vs 5.6%, P = 0.375], respectively).

Conclusion: Warfarin interruption and bridging are overwhelmingly used in warfarin-treated patients in Qatar. While bridging was numerically associated with increased bleeding events, there is no statistical difference in reported clinical events between bridging and nonbridging strategies.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Anticoagulants* / adverse effects
  • Anticoagulants* / therapeutic use
  • Elective Surgical Procedures*
  • Female
  • Hemorrhage / chemically induced*
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control
  • Heparin* / adverse effects
  • Heparin* / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Perioperative Care
  • Prospective Studies
  • Qatar
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control*
  • Treatment Outcome
  • Warfarin* / adverse effects
  • Warfarin* / therapeutic use
  • Withholding Treatment

Substances

  • Anticoagulants
  • Warfarin
  • Heparin