Perioperative interruption of direct oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation: A comparative analysis
Key result
Perioperative interruption of DOACs was associated with significantly lower 30-day postoperative major bleeding rates compared to VKAs (0.57% vs 3.62%).
Why the study?
There was a paucity of studies comparing postoperative thromboembolic and major bleeding complications following perioperative interruption of DOACs versus VKAs.
Does perioperative interruption of DOACs compared to VKAs reduce postoperative major bleeding or thromboembolic events in patients with atrial fibrillation?
Population
325 DOAC patients (351 procedures) and 199 VKA patients (221 procedures) with AF
Comparison
Perioperative interruption of DOACs vs VKAs
Design
Retrospective cohort study
Follow-up
30-day
Authors
Discussion
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Member takes
Implication
May favor DOAC over VKA interruption perioperatively in AF; leaves open randomized validation of net benefit.
Study Design
Type
Cohort (n=524)
Structured PICO
Does perioperative interruption of DOACs compared to VKAs reduce postoperative major bleeding or thromboembolic events in patients with atrial fibrillation?
P
Population
524 patients with atrial fibrillation undergoing 572 surgical procedures (325 DOAC patients undergoing 351 procedures and 199 VKA patients undergoing 221 procedures)
I
Intervention
Perioperative interruption of direct oral anticoagulants (DOACs)
C
Comparator
Perioperative interruption of vitamin K antagonists (VKAs)
O
Outcome
30-day postoperative rates of arterial thromboembolic events (ATEs) and major bleedinghard clinical
Main Result
Absolute Event Rate: 0.57% vs 3.62%
Perioperative interruption of VKAs is associated with higher postoperative major bleeding rates compared to DOACs in patients with atrial fibrillation.
Cite This Study
Shaw et al. (2020) conducted a cohort in Atrial fibrillation (n=524). Perioperative interruption of DOACs vs. Perioperative interruption of VKAs was evaluated on 30-day postoperative major bleeding. Perioperative interruption of DOACs was associated with significantly lower 30-day postoperative major bleeding rates compared to VKAs (0.57% vs 3.62%).