Risk of Thromboembolism With Short-term Interruption of Warfarin Therapy

• DOI: 10.1001/archinternmed.2007.23
• Publication Date: 2008-01-14T21:09:09Z
• Authors: David A. Garcia
• Keywords: Warfarin Sodium

<h3>Background</h3> Significant uncertainty surrounds the treatment of patients who must discontinue warfarin sodium therapy before an invasive procedure. In part, results from lack published information about risk thromboembolism associated with short-term interruption. We aimed to assess frequency and bleeding within a large cohort whose was temporarily withheld for outpatient <h3>Methods</h3> This prospective, observational study performed at 101 sites (primarily community-based physician office practices) in United States. Enrollment conducted April 4, 2000, March 6, 2002. The main outcome measures were or clinically significant hemorrhage 30 days <h3>Results</h3> A total 1293 episodes interruption 1024 individuals included. mean (SD) patient age 71.9 (10.6) years; 438 (42.8%) female. most common indications anticoagulant atrial fibrillation (n = 550), venous 144), mechanical heart valve 132). procedures colonoscopy oral ophthalmic surgery. Perioperative heparin low-molecular-weight used only 8.3% cases overall. Seven (0.7%; 95% confidence interval [CI], 0.3%-1.4%) experienced postprocedure days. None 7 received periprocedural bridging therapy. Six (0.6%; CI, 0.2%-1.3%) major bleeding, whereas additional 17 (1.7%; 1.0%-2.6%) significant, nonmajor episode. Of these 23 had episodes, 14 heparin. duration variable; however, more than 80% 5 fewer. <h3>Conclusions</h3> For many receiving long-term anticoagulation need undergo minor intervention, brief (≤5 days) is low thromboembolism. even among outpatients undergoing procedures, should be weighed against thromboembolic individual administration