No increased XXXX events with continuation of oral anticoagulation therapy for @entity1 undergoing cardiac device procedure.

@entity1 @entity548 @entity117 @entity1410 @entity1229
BACKGROUND: Switching @entity1229 for heparin has been a practice for managing periprocedural anticoagulation in high-risk @entity1 undergoing device-related procedures. We sought to investigate whether continuation of @entity1229 therapy without heparin bridging is safe and, when it is continued, the optimal international normalized ratio (INR) without increased @entity548 risk at time of device-related procedure. METHODS AND RESULTS: We retrospectively studied 766 consecutive @entity1 taking @entity1229 long term who underwent device-related procedures. @entity1 were grouped by treatment: discontinued @entity1229 (- @entity1229 , n = 243), no interruption of @entity1229 (+ @entity1229 , n = 324), and discontinued @entity1229 with heparin bridging (+heparin, n = 199). The study primary endpoint was systemic @entity548 or formation of moderate or severe pocket @entity1410 within 30 days of the procedure. Thirty-one (4%) @entity1 had @entity548 events, including pocket @entity1410 in 29 @entity1 . The @entity548 events occurred more often for +heparin (7.0%) than - @entity1229 (2.1%) or + @entity1229 (3.7%, P = 0.029). For + @entity1229 group, INR of 2.0-2.5 at time of procedure did not increase @entity548 risk compared with INR less than 1.5 (3.7% vs 3.4%; P = 0.72), but INR greater than 2.5 increased the @entity548 risk (10.0% vs 3.4%; P = 0.029). Concomitant @entity117 use with @entity1229 significantly increased @entity548 risk than @entity1229 alone (5.6% vs 1.4%, P = 0.02). Median length of hospitalization was significantly shorter for + @entity1229 than +heparin (1 vs 6 days; P < 0.001). CONCLUSION: Continuation of oral anticoagulation therapy with an INR level of <2.5 does not impose increased risk of @entity548 for device-related procedures, although precaution is necessary to avoid supratherapeutic anticoagulation levels.
