Continuing warfarin therapy is superior to interrupting warfarin with or without bridging anticoagulation therapy in patients undergoing pacemaker and defibrillator implantation

Ahmed, Imdad; Gertner, Elie; Nelson, W. Bradley; House, Chad M.; Dahiya, Ranjan; Anderson, Christopher P.; Benditt, David G.; Zhu, Dennis W

doi:10.1016/j.hrthm.2010.02.018

Cited by 94 publications

(85 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In order to perform TUR-P, the medication is often interrupted or bridged with low-molecular-weight heparin. The interruption or bridging of oral anticoagulation (OA) is associated with a higher risk of thromboembolic events; in cases of continuous OA, a higher proportion of bleeding events at the surgical site is found [3,4]. …”

Section: Introductionmentioning

confidence: 99%

Thulium Laser (Revolix) Vapoenucleation of the Prostate Is a Safe Procedure in Patients with an Increased Risk of Hemorrhage

et al. 2012

View full text Add to dashboard Cite

Purpose: To evaluate the feasibility and safety of thulium:yttrium-aluminium-garnet laser vapoenucleation of the prostate (ThuVEP) in patients with chronic anticoagulation and bleeding disorders. Methods: We retrospectively analyzed the clinical data (transfusion rate, hemoglobin changes, residual urine, bleeding complications, complications and residual urine) of patients with chronic anticoagulation and bleeding disorders treated with ThuVEP. Anticoagulation was not paused for surgery. Results: We identified 39 patients who fulfilled the inclusion criteria (32 with chronic anticoagulation, 3 with bleeding disorder, and 4 with both). Mean preoperative hemoglobin was 12.9 g/l; the postoperative hemoglobin was 11.7 g/l. One patient received a blood transfusion. Mean residual urine was 166 ml preoperatively and 47 ml postoperatively, respectively; spontaneous voiding postoperatively was feasible in 36 patients. During follow-up, 5 patients suffered from gross hematuria, which was treated conservatively. Conclusions: ThuVEP is a safe procedure in patients with therapeutic anticoagulation, bleeding disorders and platelet aggregation inhibitor medication.

show abstract

Section: Introductionmentioning

confidence: 99%

Thulium Laser (Revolix) Vapoenucleation of the Prostate Is a Safe Procedure in Patients with an Increased Risk of Hemorrhage

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Recently, there has been an increasing interest in performing the pacemaker implantation without reversal of the anticoagulant. This practice was associated with lower risk of pocket bleeding and shorter hospital stay [3,[5][6][7].…”

Section: Patient Preparationmentioning

confidence: 96%

Techniques of Permanent Pacemaker Implantation

Haghjoo¹

2012

Current Issues and Recent Advances in Pacemaker Therapy

View full text Add to dashboard Cite

“…It is possible that these bleeding events could have been avoided by using reduced doses of enoxaparin as recommended by some 39 or continuation of warfarin without bridging therapy as suggested by others. 40,41 The frequency of bleeding remained high even if these procedures were excluded. Despite these limitations, the comparative groups were similar in many demographics, including concurrent risk factors for bleeding.…”

Section: Commentmentioning

confidence: 99%

Enoxaparin Outcomes in Patients With Moderate Renal Impairment

DeCarolis¹,

Thorson²,

Clairmont³

et al. 2012

Arch Intern Med

View full text Add to dashboard Cite

Background: Enoxaparin sodium has predictable pharmacokinetics that allow for simplified dosing without laboratory monitoring. Reliance on renal function for excretion may lead to accumulation of enoxaparin in patients with moderate renal impairment. However, there is no dose adjustment recommended for these patients. We conducted a review to compare bleeding events in patients with moderate renal impairment compared with those with normal renal function.Methods: Patients received enoxaparin sodium, 1 mg/ kg, every 12 hours or 1.5 mg/kg once daily between June 1 and November 30, 2009. Moderate renal impairment was defined as creatinine clearance (CrCl) of 30 to 50 mL/min. Normal renal function was defined as CrCl greater than 80 mL/min. The primary outcome was major bleeding, defined as any bleeding resulting in death, hospital admission, lengthened hospital stay, or an emergency department visit. The secondary outcome was thromboembolism.Results: A total of 164 patients met the inclusion criteria: 105 with normal renal function and 59 with moderate renal impairment. The primary outcome occurred in 6 of 105 patients (5.7%) with normal renal function vs 13 of 59 patients (22.0%) with moderate renal impairment, representing an unadjusted odds ratio of 4.7 (95% CI, 1.7-13.0; P =.002). The odds ratio using multivariable logistic regression adjusting for differences in risk was 3.9 (95% CI, 0.97-15.6; P=.055). There was no recurrent thromboembolism in either group. Conclusions:Our results suggest an increased risk of major bleeding in patients with moderate renal impairment who receive enoxaparin. Because enoxaparin is frequently used and outcomes can be life saving or life threatening, we encourage further study of the appropriate dose in patients with moderate renal impairment.

show abstract

Continuing warfarin therapy is superior to interrupting warfarin with or without bridging anticoagulation therapy in patients undergoing pacemaker and defibrillator implantation

Cited by 94 publications

References 15 publications

Thulium Laser (Revolix) Vapoenucleation of the Prostate Is a Safe Procedure in Patients with an Increased Risk of Hemorrhage

Thulium Laser (Revolix) Vapoenucleation of the Prostate Is a Safe Procedure in Patients with an Increased Risk of Hemorrhage

Techniques of Permanent Pacemaker Implantation

Enoxaparin Outcomes in Patients With Moderate Renal Impairment

Contact Info

Product

Resources

About