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Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
BACKGROUND: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure. METHODS: We retrospectively reviewed data from consecutive p...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384737/ https://www.ncbi.nlm.nih.gov/pubmed/28408835 http://dx.doi.org/10.2147/TCRM.S130624 |
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author | Shammas, Nicolas W Shammas, Gail A Jones-Miller, Susan Gumpert, Mileah Rose Gumpert, Miranda Jade Harb, Christine Chammas, Majid Z Shammas, W John Khalafallah, Rommy A Barzgari, Amy Bou Dargham, Bassel Daher, Ghassan E Rachwan, Rayan Jo Shammas, Andrew N |
author_facet | Shammas, Nicolas W Shammas, Gail A Jones-Miller, Susan Gumpert, Mileah Rose Gumpert, Miranda Jade Harb, Christine Chammas, Majid Z Shammas, W John Khalafallah, Rommy A Barzgari, Amy Bou Dargham, Bassel Daher, Ghassan E Rachwan, Rayan Jo Shammas, Andrew N |
author_sort | Shammas, Nicolas W |
collection | PubMed |
description | BACKGROUND: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure. METHODS: We retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure. RESULTS: A total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500). CONCLUSION: Patients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure. |
format | Online Article Text |
id | pubmed-5384737 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-53847372017-04-13 Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure Shammas, Nicolas W Shammas, Gail A Jones-Miller, Susan Gumpert, Mileah Rose Gumpert, Miranda Jade Harb, Christine Chammas, Majid Z Shammas, W John Khalafallah, Rommy A Barzgari, Amy Bou Dargham, Bassel Daher, Ghassan E Rachwan, Rayan Jo Shammas, Andrew N Ther Clin Risk Manag Original Research BACKGROUND: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure. METHODS: We retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure. RESULTS: A total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500). CONCLUSION: Patients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure. Dove Medical Press 2017-03-30 /pmc/articles/PMC5384737/ /pubmed/28408835 http://dx.doi.org/10.2147/TCRM.S130624 Text en © 2017 Shammas et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Shammas, Nicolas W Shammas, Gail A Jones-Miller, Susan Gumpert, Mileah Rose Gumpert, Miranda Jade Harb, Christine Chammas, Majid Z Shammas, W John Khalafallah, Rommy A Barzgari, Amy Bou Dargham, Bassel Daher, Ghassan E Rachwan, Rayan Jo Shammas, Andrew N Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
title | Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
title_full | Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
title_fullStr | Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
title_full_unstemmed | Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
title_short | Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
title_sort | predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5384737/ https://www.ncbi.nlm.nih.gov/pubmed/28408835 http://dx.doi.org/10.2147/TCRM.S130624 |
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