Coronary artery diseaseSafety of Diagnostic Coronary Angiography During Uninterrupted Therapeutic Warfarin Treatment
Section snippets
Methods
The present study is based on computerized databases in 3 hospitals and is part of a research program in progress to assess thrombotic and bleeding complications of cardiac procedures in western Finland.8, 9 We analyzed retrospectively all consecutive patients on long-term warfarin therapy (n = 258) referred for coronary angiography from 2003 through 2005. In addition, we collected an age- (±5 years) and gender-matched control group with similar indication (acute/elective) for coronary
Results
A total of 258 patients with an indication of long-term warfarin therapy underwent coronary angiography during the study period. Baseline clinical characteristics of the study population and indications for coronary angiography are presented in Table 1. Aspirin, clopidogrel, and low-molecular-weight heparins were more often used in the control group. Femoral access was used in 44% of patients in the warfarin group and in 40% of controls with no difference in the use of closure devices. Atrial
Discussion
Our results suggest that uninterrupted therapeutic warfarin treatment does not predispose a patient to excessive bleeding or access site complications during coronary angiography. However, supratherapeutic INR levels seem to be associated with access site complications. Of note, the 2 major bleeding events leading to blood transfusions occurred in patients with concomitant low-molecular-weight heparin therapy.
It is estimated that 5% of patients undergoing coronary angiography are on long-term
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This study was supported by grants from the Finnish Foundation for Cardiovascular Research, Helsinki, Finland.