Safety of coronary angiography and percutaneous coronary intervention in patients on uninterrupted warfarin therapy: a meta-analysis

Performing diagnostic radial access coronary angiography on uninterrupted direct oral anticoagulant therapy: a prospective analysis

“…Similar to previous studies involving anticoagulation with warfarin,2–7 the results of our study suggest that continuation of DOAC is also safe with no major complications or bleeding as defined by the TIMI criteria. One of the studies using warfarin as the anticoagulant reported multiple bleeding complications including bleeding delaying discharge, pseudoaneurysm, need for corrective surgery and transfusion of blood products 4.…”

“…In recent years direct oral anticoagulants (DOACs) have become a popular choice for the prevention and management of thromboembolism, and it is estimated that one in six patients on DOACs will undergo an invasive procedure every year 1. Discontinuation of anticoagulation prior to interventional procedures such as coronary angiography had been an accepted practice in the past 2. It was assumed that continuation of anticoagulation would increase haemorrhagic and access site complications 3.…”

“…It was assumed that continuation of anticoagulation would increase haemorrhagic and access site complications 3. However, much research has been published in the last decade on the use of continuous uninterrupted anticoagulation with warfarin therapy in patients undergoing coronary angiography 2–7. Many studies reached the conclusion that angiography with uninterrupted warfarin therapy was safe or appeared safe in selected patients and that it was an alternative for consideration 3 5 6.…”

“…Many studies reached the conclusion that angiography with uninterrupted warfarin therapy was safe or appeared safe in selected patients and that it was an alternative for consideration 3 5 6. Two meta-analyses reported that uninterrupted anticoagulation with warfarin appeared safe but that further evidence in the form of randomised control trials were needed 2 7. The recent American College of Cardiology (ACC) expert consensus suggested that procedures with low bleed risk can be performed on patients in the absence of patient related factors that increase risk of bleeding without interrupting anticoagulation therapy for more than 24 hours 8.…”

Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction in a Patient Taking Dabigatran for Chronic Anticoagulation

“…The authors reported no excessive bleeding in the uninterrupted-warfarin group. In addition, results of 2 meta-analyses 11,12 showed that elective coronary angiography with or without PCI appeared to be safe in patients with a therapeutic INR (range, 2-3).…”