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Anticoagulant therapy during cardiovascular implantable electronic device procedures

AIM: The objective of the study is to systematically evaluate the safety and efficacy of peri-procedural utilization of anticoagulation therapy during cardiovascular implantable electronic device procedures. MATERIAL AND METHODS: The review materials were based on comprehensive retrieval of randomiz...

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Autores principales: Daubaraitė, Aurelija, Marinskis, Germanas, Račkauskas, Gediminas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351075/
https://www.ncbi.nlm.nih.gov/pubmed/37465619
http://dx.doi.org/10.5114/aic.2023.129207
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author Daubaraitė, Aurelija
Marinskis, Germanas
Račkauskas, Gediminas
author_facet Daubaraitė, Aurelija
Marinskis, Germanas
Račkauskas, Gediminas
author_sort Daubaraitė, Aurelija
collection PubMed
description AIM: The objective of the study is to systematically evaluate the safety and efficacy of peri-procedural utilization of anticoagulation therapy during cardiovascular implantable electronic device procedures. MATERIAL AND METHODS: The review materials were based on comprehensive retrieval of randomized controlled trials and observational studies published until April 2023. Studies which compared different management strategies of long-term anticoagulation therapy during peri-procedural cardiac rhythm device implantation and compared the complications of bleeding and/or thromboembolic events were selected and reviewed. RESULTS: Studies analysing non-vitamin K oral anticoagulants interruption versus continuation during peri-procedural implantable cardiac device surgery found no statistically significant difference in bleeding or thromboembolic complications between these strategies. Studies comparing non-vitamin K oral anticoagulants with vitamin K antagonists also showed no statistically significant difference. One study comparing uninterrupted warfarin with interrupted warfarin with heparin bridging reported a reduced incidence of clinically significant device pocket haematoma in patients with continued warfarin treatment (relative risk = 0.19; 95% confidence interval: 0.10 to 0.36; p < 0.001). A sub-analysis of one study comparing dabigatran versus warfarin with heparin bridging and without bridging reported a lower risk of pocket haematoma with dabigatran when compared to warfarin with heparin bridging (risk difference: –8.62%, 95% confidence interval: –24.15 to –0.51%; p = 0.034). Both bleeding and thromboembolic complications were rare. CONCLUSIONS: The traditional method of vitamin K antagonists interruption with heparin bridging is less safe than continuing vitamin K antagonists at therapeutic levels. Both continuation and interruption strategies of non-vitamin K anticoagulants during cardiac device surgery seem to be safe and appropriate.
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spelling pubmed-103510752023-07-18 Anticoagulant therapy during cardiovascular implantable electronic device procedures Daubaraitė, Aurelija Marinskis, Germanas Račkauskas, Gediminas Postepy Kardiol Interwencyjnej Review Paper AIM: The objective of the study is to systematically evaluate the safety and efficacy of peri-procedural utilization of anticoagulation therapy during cardiovascular implantable electronic device procedures. MATERIAL AND METHODS: The review materials were based on comprehensive retrieval of randomized controlled trials and observational studies published until April 2023. Studies which compared different management strategies of long-term anticoagulation therapy during peri-procedural cardiac rhythm device implantation and compared the complications of bleeding and/or thromboembolic events were selected and reviewed. RESULTS: Studies analysing non-vitamin K oral anticoagulants interruption versus continuation during peri-procedural implantable cardiac device surgery found no statistically significant difference in bleeding or thromboembolic complications between these strategies. Studies comparing non-vitamin K oral anticoagulants with vitamin K antagonists also showed no statistically significant difference. One study comparing uninterrupted warfarin with interrupted warfarin with heparin bridging reported a reduced incidence of clinically significant device pocket haematoma in patients with continued warfarin treatment (relative risk = 0.19; 95% confidence interval: 0.10 to 0.36; p < 0.001). A sub-analysis of one study comparing dabigatran versus warfarin with heparin bridging and without bridging reported a lower risk of pocket haematoma with dabigatran when compared to warfarin with heparin bridging (risk difference: –8.62%, 95% confidence interval: –24.15 to –0.51%; p = 0.034). Both bleeding and thromboembolic complications were rare. CONCLUSIONS: The traditional method of vitamin K antagonists interruption with heparin bridging is less safe than continuing vitamin K antagonists at therapeutic levels. Both continuation and interruption strategies of non-vitamin K anticoagulants during cardiac device surgery seem to be safe and appropriate. Termedia Publishing House 2023-06-30 2023-06 /pmc/articles/PMC10351075/ /pubmed/37465619 http://dx.doi.org/10.5114/aic.2023.129207 Text en Copyright: © 2023 Termedia Sp. z o. o. https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Review Paper
Daubaraitė, Aurelija
Marinskis, Germanas
Račkauskas, Gediminas
Anticoagulant therapy during cardiovascular implantable electronic device procedures
title Anticoagulant therapy during cardiovascular implantable electronic device procedures
title_full Anticoagulant therapy during cardiovascular implantable electronic device procedures
title_fullStr Anticoagulant therapy during cardiovascular implantable electronic device procedures
title_full_unstemmed Anticoagulant therapy during cardiovascular implantable electronic device procedures
title_short Anticoagulant therapy during cardiovascular implantable electronic device procedures
title_sort anticoagulant therapy during cardiovascular implantable electronic device procedures
topic Review Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351075/
https://www.ncbi.nlm.nih.gov/pubmed/37465619
http://dx.doi.org/10.5114/aic.2023.129207
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