Safety of percutaneous coronary intervention during uninterrupted oral anticoagulant treatment

Abstract

Our study shows that PCI is a safe procedure during UAC with no excess bleeding complications.

Risk factors for bleeding complications in patients undergoing transcatheter aortic valve implantation (TAVI)

“…This is particularly important as the scheme of DAPT was proposed as a standard of treatment before conducion of studies on this population of patients [2]. Most of the reports regarding the risk of combined therapy with DAPT comes from the studies on patients with acute coronary syndrome [3,[19][20][21][22]. It is known that bleeding complications are observed in 2-8% of patients with coronary artery disease and are more frequent in women, in elderly, in patients with renal dysfunction and those with a history of bleeding [3][4][5].…”

“…It is known that bleeding complications are observed in 2-8% of patients with coronary artery disease and are more frequent in women, in elderly, in patients with renal dysfunction and those with a history of bleeding [3][4][5]. Many studies confirmed that the use of DAPT with oral anticoagulants efficiently reduces the risk of recurrent coronary incidents, but is related to worse prognosis due to increased risk of bleeding [19][20][21][22]. Chronic use of triple anticoagulant therapy (TAT) in population of patients > 75 years of age is related to 15% risk of bleeding complications per each year of treatment [22].…”

“…Chronic use of triple anticoagulant therapy (TAT) in population of patients > 75 years of age is related to 15% risk of bleeding complications per each year of treatment [22]. In a retrospective analysis Karjalainen et al [19] found that TAT is related to higher frequency of bleeding complications (11.4%) and worse 1-year prognosis. Similarly Manzano-Fernández et al [21] confirmed that TAT is an independent risk factor of bleeding in long-term observation.…”

“…bleeding complications [23,27]. In a retrospective analysis Karjalainen et al [19] suggested that the safest therapy in patients undergoing percutaneous coronary interventions (PCI) with high risk of bleeding consists of the combination of VKA and clopidgrel. Monotherapy with VKA after 1 year of combined treatment is also considered as the safest one in patients with AF after PCI [21,22].…”

Anticoagulation management in nonvalvular atrial fibrillation: current and future directions

“…67 Continuation of VKA (with the INR within the therapeutic range) is also recommended for PCI in the setting of an acute coronary syndrome (ACS). [64][65][66]68 However, NOACs should be temporarily discontinued in all patients presenting with an ACS.…”