In a recent research report, it has been highlighted that Interrupted Oral Anticoagulant ( I-OAC) and Uninterrupted Oral Anticoagulant Therapy (U-OAC) have equivalent risk for major adverse cardiac and cerebrovascular events and bleeding complications. Rather, it was noted that an U-OAC strategy was associated with shorter length of hospitalization. These data further support U-OAC as the preferable strategy in patients on OAC undergoing coronary intervention. Findings have been published in Journal of the American College of Cardiology.
There is a paucity of data regarding the optimal peri-procedural management of OAC-treated patients. So, this recent study sought to compare interrupted and uninterrupted oral anticoagulant therapy (I-OAC vs. U-OAC) in patients on OAC undergoing percutaneous coronary intervention.
For the study design,in the SWEDEHEART registry, all patients on OAC who were admitted acutely and underwent percutaneous coronary intervention or coronary angiography with a diagnostic procedure, from 2005 to 2017, were included. Outcomes were major adverse cardiac and cerebrovascular events (MACCE; death, myocardial infarction, or stroke) and bleeds at 120 days. Propensity score was used to adjust for the nonrandomized treatment selection.
Data analysis revealed some new facts.
The study included 6,485 patients: 3,322 in the I-OAC group and 3,163 in the U-OAC group. The cumulative incidence of MACCE was 8.2% (269 events) versus 8.2% (254 events) in the I-OAC and the U-OAC groups, respectively.
The adjusted risk for MACCE did not differ between the groups (I-OAC vs. U-OAC hazard ratio: 0.89; 95% confidence interval: 0.71 to 1.12).
Similarly, no difference was found in the risk for MACCE or bleeds (12.6% vs. 12.9%, adjusted hazard ratio: 0.87; 95% confidence interval: 0.70 to 1.07). The risk for major or minor in-hospital bleeds did not differ between the groups.
However, U-OAC was associated with a significantly shorter duration of hospitalization: 4 (3 to 7) days versus 5 (3 to 8) days; p < 0.01.
For full article follow the link:Uninterrupted Oral Anticoagulant Therapy in Patients Undergoing Unplanned Percutaneous Coronary Intervention
JACC Cardiovasc Interv 2021 Apr 12;14(7)754-763, D Venetsanos, M Skibniewski, M Janzon, SS Lawesson, E Charitakis, F Böhm, L Henareh, P Andell, LO Karlson, M Simonsson, S Völz, D Erlinge, E Omerovic, J Alfredsson
Primary source: Journal of the American College of Cardiology