Key result
Antithrombotic therapy during pericardiocentesis was associated with a 2.9% rate of mild, self-resolving oozing compared to 0% in controls, with no major bleeding complications observed in either group.
Why the study?
The safety of pericardiocentesis performed without discontinuing anticoagulant or antiplatelet drugs had not been well evaluated.
Does pericardiocentesis without discontinuation of antithrombotic therapy increase bleeding complications in patients with pericardial effusion?
Observational (n=501)
No
Does pericardiocentesis without discontinuation of antithrombotic therapy increase bleeding complications in patients with pericardial effusion?
Absolute Event Rate: 2.9% vs 0%
p-value: p=0.019
Pericardiocentesis can be safely performed in patients on antithrombotic therapy without an increased risk of major bleeding complications.
May support continuing antithrombotics during pericardiocentesis without major bleeding; leaves open prospective confirmation before practice change.
Objective This study aimed to analyze the characteristics of patients with pericardial effusion requiring pericardiocentesis and to evaluate the safety of pericardiocentesis without discontinuation of anticoagulant or antiplatelet drugs. Methods We performed a retrospective study of patients undergoing pericardiocentesis in our hospital between 2012 and 2022. Patients were categorized into the Antithrombotic Group if they had used any antiplatelet or anticoagulant drugs on the day of pericardiocentesis; otherwise they were categorized into the Non-antithrombotic Group. All procedures were performed by experienced cardiologists with echocardiographic guidance. Bleeding events were defined using the National Institutes of Health scale of adverse events. Results A total of 501 consecutive patients were identified and 70 cases were under antithrombotic drugs (Antithrombotic Group). Patients in Antithrombotic Group were older, had more comorbidities, presented with lower platelet counts and prolonged activated partial thromboplastin time (all p < 0.05). Malignancy was the most common etiology for pericardial effusion in both groups (28.6% in Antithrombotic Group and 54.7% in Non-antithrombotic Group) and tuberculosis was the second etiology in the Non-antithrombotic Group (21.9%), while procedure-related effusion (17.1%) accounted for the second cause in the Antithrombotic Group. Two patients in the Antithrombotic Group had mild oozing at the puncture site that resolved without interventions (2.9 vs. 0%, p = 0.019), and no bleeding events higher than Grade 1 occurred in either group. Conclusion Although antiplatelet or anticoagulant drugs may put patients undergoing pericardiocentesis at theoretically higher risk of bleeding, our study demonstrated that they are not associated with increased major bleeding complications.
No takes yet. Share an insight, caveat, or question.
Zhu et al. (2022) conducted an observational in Pericardial effusion requiring pericardiocentesis (n=501). Antithrombotic therapy (antiplatelet or anticoagulant drugs) vs. No antithrombotic therapy was evaluated on Any bleeding events (p=0.019). Antithrombotic therapy during pericardiocentesis was associated with a 2.9% rate of mild, self-resolving oozing compared to 0% in controls, with no major bleeding complications observed in either group.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: