Comparison of safety between continued warfarin therapy and bridging anticoagulation therapy in patients undergoing coronary intervention / 中华心血管病杂志

ABSTRACT

Objective@#To compare the safety of continued warfarin therapy and bridging anticoagulation therapy during hospital stay in patients undergoing percutaneous coronary intervention (PCI). @*Methods@#We retrospectively analyzed patients on warfarin therapy referred for PCI in Beijing Anzhen Hospital from January 2008 to December 2016. The patients were divided into continued warfarin therapy (n=195) or bridging anticoagulation therapy (n=311) groups. After Propensity Score Matching, data from matched patients (n=123 in each group) were analyzed. Bleeding complications and major adverse cardiac events including death, myocardial infarction, target vessel revascularization, and stent thrombosis were assessed. @*Results@#There were no significant difference in the rate of death (2.4%(3/123) vs. 1.6%(2/123),P=0.54), acute myocardial infarction (4.1%(5/123) vs. 4.9%(6/123), P=0.78),re-revascularization (0.8%(1/123) vs. 1.6%(2/123),P=0.16), stent thrombosis (1.6%(2/123) vs. 1.6%(2/123),P=1.00) and stroke between the two groups. Prevalence of minor bleeding complications was significantly higher in the bridging therapy group (15.4%(19/123) vs. 9.8%(12/123),P=0.01). Rate of access-site complications (hematoma4.1%(5/123) vs. 2.4%(3/123),P=0.20; pseudoaneurysm2.4%(3/123) vs. 2.4%(3/123),P=1.00; arteriovenous fistula0.8%(1/123) vs. 1.6%(2/123),P=0.09; and retroperitoneal hematoma0(0/123) vs. 0.8%(1/123),P=0.23) were similar between the two groups. @*Conclusion@#For patients receiving chronic warfarin therapy, the uninterrupted oral anticoagulant treatment is as safe as bridging therapy in PCI patients.