COMPARISON OF SCHEMES OF PERIOPERATIONAL ANTICOAGULATION IN ATRIAL FIBRILLATION PATIENTS DEMANDING FOR SURGERY

A literature review provided, on the usage of various schemes of perioperational anticoagulation therapy (ACT) in atrial fibrillation patients undergoing scheduled surgery. It is noted that clinicians quite often pass through a situation when patients taking ACT require invasive investigations and surgery. Perioperational management of such category of patients is complicated as, on the one hand, the surgery under ACT is associated with intraoperational hemorrhagic complications, and, on the other hand, ACT cessation might increase the risk of thrombotic complications. The variants assessed, of different periprocedural ACT in patients taking vitamin K antagonists. It was found that as an alternative to continuous ACT recently, bridge therapy with low molecular weight heparins applied, aiming the decrease of the risk of bleeding in adequate thromboprophylaxis. The results of clinical trials provided on the assessment of bridge therapy in surgery. Risk stratification approaches presents for thromboembolic and hemorrhagic complications in surgery.

1. Liu S, Li X, Shi Q, et al. Outcomes associated with warfarin time in therapeutic range among US veterans with nonvalvular atrial fibrillation. Curr Med Res Opin. 2017; 25: 1-25. DOI: 10.1080/03007995.2017.1384370.

2. Kolbin AS, Tatarskiy BA, Biserova IN, et al. Socio-economic burden of atrial fibrillation in the Russian Federation. Clinical pharmacology and therapy 2010; 19 (4): 19-22. (In Russ.)

3. Serdechnaya EV, Kazakevich EV, Tatarskiy BA. Features of prevalence and course of atrial fibrillation in the Northwest of the Russian Federation. Clinical medicine 2009; 1: 17-20. (In Russ.).

4. Nishtala A, Piers RJ, Himali JJ, et al. Atrial Fibrillation and Cognitive Decline in the Framingham Heart Study. Heart Rhythm. 2017; Sep 22. pii: S1547-5271(17)31133-5. DOI: 10.1016/j.hrthm.2017.09.036.

5. Guenancia C, Garnier F, Mouhat B, et al. Screening and clinical implications of silent atrial fibrillation. Rev Med Interne 2017; Sep 21. pii: S0248-8663(17)30632-X. DOI: 10.1016/j.revmed.2017.08.006.

6. Siegal D, Yudin J, Kaatz S, et al. Periprocedural heparin bridging in patients receiving vitamin K antagonists: systematic reviewand meta-analysis of bleeding and thromboembolic rates. Circulation 2012; 126 (13): 1630-9.

7. Gorenek B, Lip GY. Recent scientific documents from the European Heart Rhythm Association (EHRA). Europace 2015; 17 (8): 1161-3. DOI: 10.1093/europace/euv193.

8. Bansal VK, Herzog CA, Sarnak MJ, et al. Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report. Am J Kidney Dis 2017; 70 (6): 859-68. DOI: 10.1053/j.ajkd.2017.08.003.

9. Denas G, Gennaro N, Ferroni E, et al. Effectiveness and safety of oral anticoagulation with non-vitamin K antagonists compared to well-managed vitamin K antagonists in naive patients with non-valvular atrial fibrillation: Propensity score matched cohort study. Int J Cardiol 2017; 249: 198-203. DOI: 10.1016/j.ijcard.2017.09.029.

10. Vinereanu D, Al-Khalidi HR, Rao MP, et al. Regional differences in presentation and antithrombotic treatment of patients with atrial fibrillation: Baseline characteristics from a clustered randomized trial to IMProve treatment with AntiCoagulanTs in patients with atrial fibrillation (IMPACT-AF). Am Heart J 2017; 192: 38-47. DOI: 10.1016/j.ahj.2017.07.004.

11. Lip GY, Laroche C, Popescu MI, et al. Improved outcomes with European Society of Cardiology guideline-adherent antithrombotic treatment in high-risk patients with atrial fibrillation: a report from the EORP-AF General Pilot Registry. Europace 2015; 17 (12): 1777-86. DOI: 10.1093/europace/euv269.

12. Rechenmacher SJ, Fang JC. Bridging Anticoagulation: Primum Non Nocere. JACC 2015; 66 (12): 1392-403. DOI: 10.1016/j.jacc.2015.08.002.

13. Petit-Moneger A, Thiessard F, Noize P, et al. Definition of indicators of the appropriateness of oral anticoagulant prescriptions in hospitalized adults: Literature review and consensus (PACHA study). Arch Cardiovasc Dis 2017 Sep 21. pii: S18752136, (17)30154-7. DOI: 10.1016/j.acvd.2017.05.005.

14. Caprini JA, Traverso CI, Arcelus JI. Perspectives on thromboelastography. Semin Thromb Hemost 1995; 21: 91-3.

15. Wysokinski WE, McBane RD. Periprocedural bridging management of anticoagulation. Circulation 2012; 126: 486-90. DOI: 10.1161/CIRCULATIONAHA.112.092833.

16. Clark NP, Witt DM, Davies LE, et al. Bleeding, recurrent venous thromboembolism, and mortality risks during warfarin interruption for invasive procedures. JAMA Intern Med 2015; 175: 1163-8. DOI: 10.1001/jamainternmed.2015.1843.

17. Brotman DJ, Streiff MB. Overuse of bridging anticoagulation for patients with venous thromboembolism: first, do no harm. JAMA Intern Med 2015; 175: 1169-70. DOI: 10.1001/jamainternmed.2015.1858.

18. Steinberg BA, Peterson ED, Kim S, et al. Use and outcomes associated with bridging during anticoagulation interruptions in patients with atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Circulation 2015; 131: 488-94. DOI: 10.1161/CIRCULATIONAHA.114.011777.

19. Douketis JD, Spyropoulos AC, Kaatz S, et al. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med 2015; 373: 823-33. DOI: 10.1056/NEJMoa1501035.

20. Douketis JD, Spyropoulos AC, Spencer FA, et al. Perioperative management of antithrombotic therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141: 326-50. DOI: 10.1378/chest.11-2298.

21. Tafur AJ, McBane R, Wysokinski WE, et al. Predictors of major bleeding in periprocedural anticoagulation management. J Thromb Haemost 2012; 10: 2617. DOI: 10.1111/j.1538-7836.2011.04572.x.

22. Cavalcanti R, Rosenbaum B, Benzel E, Varma N. “Safe period” of anticoagulation withdrawal in patients with mechanical heart valve(s). JACC 2015; 65: A2035.

23. Jaffer AK, Brotman DJ, Bash LD, et al. Variations in perioperative warfarin management: outcomes and practice patterns at nine hospitals. Am J Med 2010; 123: 141-50. DOI: 10.1016/j.amjmed.2009.09.017.

24. Granger CB, Lopes RD, Hanna M, et al. Clinical events after transitioning from apixaban versus warfarin to warfarin at the end of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTHLE) trial. Am Heart J 2015; 169: 25-30. DOI: 10.1016/j.ahj.2014.09.006.

25. Heidbuchel H, Verhamme P, Alings M, et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Eur Heart J 2017; 38 (27): 2137-49. DOI: 10.1093/eurheartj/ehw058.

26. Ezekowitz MD, Nagarakanti R, Noack H, et al. Comparison of Dabigatran and Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: The RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulant Therapy). Circulation 2016; 134 (8): 589-98. DOI: 10.1161/CIRCULATIONAHA.115.020950.