دورية أكاديمية
Meta-analysis of continuous oral anticoagulants versus heparin bridging in patients undergoing CIED surgery: reappraisal after the BRUISE study.
| العنوان: | Meta-analysis of continuous oral anticoagulants versus heparin bridging in patients undergoing CIED surgery: reappraisal after the BRUISE study. |
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| المؤلفون: | Sant'anna RT; Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil., Leiria TL, Nascimento T, Sant'anna JR, Kalil RA, Lima GG, Verma A, Healey JS, Birnie DH, Essebag V |
| المصدر: | Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2015 Apr; Vol. 38 (4), pp. 417-23. Date of Electronic Publication: 2014 Dec 26. |
| نوع المنشور: | Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Futura Pub. Co. Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978- |
| مواضيع طبية MeSH: | Anticoagulants/*administration & dosage , Hemorrhage/*epidemiology , Heparin/*administration & dosage , Prosthesis Implantation/*statistics & numerical data , Thromboembolism/*epidemiology , Thromboembolism/*prevention & control, Administration, Oral ; Aged ; Comorbidity ; Defibrillators, Implantable/statistics & numerical data ; Female ; Hemorrhage/prevention & control ; Humans ; Incidence ; Male ; Pacemaker, Artificial/statistics & numerical data ; Premedication/statistics & numerical data ; Risk Assessment ; Treatment Outcome ; Vitamin K/antagonists & inhibitors |
| مستخلص: | Background: Management of patients treated with oral anticoagulation (OAC) requiring a cardiovascular implantable electronic device (CIED) surgery is a challenge that requires balancing the risk of bleeding complications with the risk of thromboembolic events. Recently the approach of performing these procedures while the patient remains with a therapeutic international normalized ratio has gained interest due to several publications showing its relative safety. Objectives: To evaluate the safety and effectiveness of continuous use of OAC compared with heparin bridging in the perioperative setting of CIED surgery using a meta-analysis. Methods: A systematic review of PubMed/MEDLINE, Ovid, and Elsevier databases was performed. Eligible randomized controlled trials and cohort studies were included. The outcomes studied were risk of clinically significant bleeding and of thromboembolic events. Our analysis was restricted to OAC with vitamin K antagonists. Results: Of 560 manuscripts initially considered relevant, seven were included in the meta-analysis, totaling 2,191 patients. Data are reported as odds ratios (ORs) with confidence interval (CI) of 95%. Maintenance of OAC was associated with a significantly lower risk of postoperative bleeding compared with heparin bridge (OR = 0.25, 95% CI 0.17-0.36, P < 0.00001). There was no difference noted in the risk of thromboembolic events between the two strategies (OR = 1.86, 95% CI 0.29-12.17, P = 0.57). Conclusions: Uninterrupted use of OAC in the perioperative of CIED surgery was associated with a reduced risk of bleeding. This strategy should be considered the preferred one in patients at moderate-to-high risk of thromboembolic events. (© 2014 Wiley Periodicals, Inc.) |
| معلومات مُعتمدة: | Canada Canadian Institutes of Health Research |
| فهرسة مساهمة: | Keywords: CRT; defibrillation - ICD; pacing |
| المشرفين على المادة: | 0 (Anticoagulants) 12001-79-5 (Vitamin K) 9005-49-6 (Heparin) |
| تواريخ الأحداث: | Date Created: 20141230 Date Completed: 20160314 Latest Revision: 20181202 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1111/pace.12557 |
| PMID: | 25546244 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1540-8159 |
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| DOI: | 10.1111/pace.12557 |