| Autor: |
Zhang XJ; Department of Cardiology, Beijing Anzhen Hospital of the Capital University of Medical Sciences, Beijing 100029, China., Yan HB, Chi YP, Zhao QM, Tian L, Zhang M, Wang GZ, Zhang XX, Chen Q |
| Abstrakt: |
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 (hematoma:4.1%(5/123) vs. 2.4%(3/123), P= 0.20; pseudoaneurysm:2.4%(3/123) vs. 2.4%(3/123), P= 1.00; arteriovenous fistula:0.8%(1/123) vs. 1.6%(2/123), P= 0.09; and retroperitoneal hematoma:0(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. |
