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- W2013984906 abstract "In the current issue of Circulation , Steinberg et al1 describe the use and outcomes associated with bridging anticoagulation (AC) in patients with atrial fibrillation (AF) in the contemporary Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF). Chronic oral anticoagulation (OAC) significantly reduces the risk of stroke or thromboembolism in patients with AF. Despite the growing population burden of AF,2 the increasing use of OAC, and the frequent need for cardiac and noncardiac procedures in this population, remarkably little contemporary data exist to help guide the clinician with respect to periprocedural AC decision making. Although guidelines exist on the topic, they are based on limited and largely observational data.3,4 Current guideline-supported periprocedural AC management supports the discontinuation of OAC and the use of short-acting AC, most commonly low-molecular-weight heparin or unfractionated heparin, to bridge AF patients at high risk for thromboembolic complications during the immediate pre- and postprocedure period (American College of Chest Physicians grade 2C; American Heart Association grade 1C).3,4Article see p 488“To bridge or not to bridge,” is a question often asked in clinical practice, with an estimated 250 000 patients on OAC undergoing cardiac and noncardiac procedures annually in North America.3 The authors are therefore to be congratulated for examining the topic of use and outcomes of bridging AC in an effort to better inform us and enhance the safety of our AF patients. Currently, the periprocedural management of patients who are receiving OAC is often informed by a clinician’s (1) assessment of patient risk for thromboembolism, (2) assessment of risk for perioperative bleeding, and (3) the type of procedure. Although CHADS2, CHA2DS2-VASc, HAS-BLED, and ATRIA scores are used in clinical practice to assess the risks of …" @default.
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- W2013984906 date "2015-02-03" @default.
- W2013984906 modified "2023-10-16" @default.
- W2013984906 title "A Bridge Too Far?" @default.
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- W2013984906 doi "https://doi.org/10.1161/circulationaha.114.014319" @default.
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