Comparison of Outcomes in Patients Undergoing Periprocedural Interruption of Warfarin or Direct Oral Anticoagulants
Research and Practice in Thrombosis and Haemostasis
Background : There is limited data comparing post- procedural outcomes in patients following the interruption of warfarin or direct oral anticoagulants (DOACs). Existing studies do not control for differences in patient characteristics when comparing outcomes. Aims : To determine if there is a difference in post- procedural outcomes in patients with interruption of warfarin or DOACs. Methods : Data from 2012 to 2018 from six anticoagulation clinics participating in the Michigan Anticoagulation Quality Improvement Initiative (MAQI2) was analyzed. Patients having at least one interruption for a procedure were identified. Each DOAC patient was matched to one or more warfarin patients, with exact matching on gender and procedure bleed risk and propensity score matching across other clinical variables. Bleeding and thromboembolic events within 30 days from the procedure were then compared between the matched cohorts using the Poisson distribution test. Results : A total of 273 DOAC patients were matched with 683 warfarin patients (Table 1). The occurrence of non- major bleeds (5.0% vs 6.6%, p=0.32), major bleeds (0.9% vs. 1.5%, p=0.42), and thromboembolic events (0.29% vs 0.37%, p=0.85) was similar between the warfarin and DOAC cohorts, respectively (Table 2). Conclusions : Our findings suggest that, following periprocedural interruption, warfarin and DOAC patients have similar bleeding and thromboembolic events. Further research investigating the periprocedural outcomes of these two classes of anticoagulants is warranted. (Table Presented).
Lee J, Haymart B, Kong X, Kaatz S, Shah V, Kozlowski J, Ali M, Kline-Rogers E, Froehlich JB, and Barnes GD. Comparison of Outcomes in Patients Undergoing Periprocedural Interruption of Warfarin or Direct Oral Anticoagulants. Res Pract Thromb Haemost 2019; 3 (Suppl.1):732-733.