Why the study?
Real-world evidence on the perioperative management of antithrombotic therapy according to current recommendations is scarce.
Does inappropriate perioperative management of antithrombotic therapy increase adverse thrombotic and hemorrhagic events in patients undergoing surgery or invasive interventions?
Does inappropriate perioperative management of antithrombotic therapy increase adverse thrombotic and hemorrhagic events in patients undergoing surgery or invasive interventions?
In real-world practice, adherence to perioperative antithrombotic guidelines is poor (57.3%), and inappropriate management significantly increases the risk of 30-day thrombotic and bleeding events.
Perioperative antithrombotic management varies in real-world practice; leaves open optimal strategies to minimize thrombotic and bleeding events.
INTRODUCTION AND OBJECTIVES: There is scarce real-world evidence on the management of perioperative antithrombotic treatment according to current recommendations. The aim of this study was to analyze the management of antithrombotic treatment in patients undergoing surgery or another invasive intervention and to assess the consequences of this management on the occurrence thrombotic or bleeding events. METHODS: This prospective, observational, multicenter and multispecialty study analyzed patients receiving antithrombotic therapy who underwent surgery or another invasive intervention. The primary endpoint was defined as the incidence of adverse (thrombotic and/or hemorrhagic) events after 30 days of follow-up with respect to management of perioperative antithrombotic drugs. RESULTS: : 3.7), while 53.3% of the patients were under chronic antiplatelet therapy (mainly for coronary artery disease). Low ischemic and hemorrhagic risk was found in 66.7% and 51.9%, respectively. Antithrombotic therapy management was in line with current recommendations in only 57.3% of the patients. Inappropriate management of antithrombotic therapy was an independent risk factor for both thrombotic and hemorrhagic events. CONCLUSIONS: The implementation of recommendations on the perioperative/periprocedural management of antithrombotic therapy in real-world patients is poor. Inappropriate management of antithrombotic treatment is associated with an increase in both thrombotic and hemorrhagic events.
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Vivas et al. (2023) studied this question.
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