Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants
ABSTRACT Introduction and objectives: Today it has become increasingly common to perform procedures without withdrawing oral anticoagulation. However, the need to withdraw oral anticoagulants prior to cardiac catheterization in patients chronically anticoagulated (OACs) remains controversial. We eva...
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| Format: | Article |
| Language: | English |
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Permanyer
2019-08-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
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| Online Access: | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=157 |
| _version_ | 1818355164285763584 |
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| author | Cristina Ramírez Guijarro Antonio Gutiérrez Díez Juan Gabriel Córdoba Soriano Arsenio Gallardo López Driss Melehi El-Assali Juan José Portero Portaz Javier Navarro Cuartero Jesús Jiménez Mazuecos |
| author_facet | Cristina Ramírez Guijarro Antonio Gutiérrez Díez Juan Gabriel Córdoba Soriano Arsenio Gallardo López Driss Melehi El-Assali Juan José Portero Portaz Javier Navarro Cuartero Jesús Jiménez Mazuecos |
| author_sort | Cristina Ramírez Guijarro |
| collection | DOAJ |
| description | ABSTRACT Introduction and objectives: Today it has become increasingly common to perform procedures without withdrawing oral anticoagulation. However, the need to withdraw oral anticoagulants prior to cardiac catheterization in patients chronically anticoagulated (OACs) remains controversial. We evaluated the efficacy and safety of performing transradial catheterization in outpatients without withdrawing direct-action oral anticoagulants (DOACs). Methods: Prospective and observational study where 270 patients who underwent elective transradial cardiac catheterization were included from January 2013 through November 2017, divided into 3 groups of 90 patients based on their anticoagulant intake: group A (without OAC), with group B (with vitamin K antagonist), and group C (with DOACs), and matched according to the date of completion. In no case was the OAC discontinued before the procedure. We evaluated the complications of radial access within the first 24 h and 1 month after the procedure. Results: The group of patients on DOACs had a higher proportion of men compared to the vitamin K antagonist group (71.1% vs 47.8%; P = .01) and patients were younger in the group without OAC (63.45 ± 11.47 vs 70.22 ± 9.35; P = .03). Group B had a lower percentage of diabetic patients (22.2% vs 36.67% in group C, P = .03). In group A, patients were more prone to having a history of ischemic heart disease compared to the groups of anticoagulated patients (27.84% vs 14.44% in group C, P = .028) in addition to a more frequent intake of antiplatelet drugs. Radial access was the access of choice in most patients (98.2%). There were no significant differences when it comes to vascular access complications among the groups being the rate of hematoma and/or bleeding at discharge equal to 1.1% in the DOACs group and the arterial occlusion rates both at discharge and at 1 month between 0% and 2.2%. Conclusions: In our experience performing transradial diagnostic cardiac catheterizations without discontinuation of DOACs is safe, with low rates of thrombotic and hemorrhagic complications, without any differences with vitamin K antagonist and no OAC. |
| first_indexed | 2024-12-13T19:36:58Z |
| format | Article |
| id | doaj.art-3774a10df71d47ceb642a8b04dcf21b5 |
| institution | Directory Open Access Journal |
| issn | 2604-7322 |
| language | English |
| last_indexed | 2024-12-13T19:36:58Z |
| publishDate | 2019-08-01 |
| publisher | Permanyer |
| record_format | Article |
| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj.art-3774a10df71d47ceb642a8b04dcf21b52022-12-21T23:33:47ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222019-08-011316116610.24875/RECICE.M19000038Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulantsCristina Ramírez Guijarro0Antonio Gutiérrez Díez1Juan Gabriel Córdoba Soriano2Arsenio Gallardo López3Driss Melehi El-Assali4Juan José Portero Portaz5Javier Navarro Cuartero6Jesús Jiménez Mazuecos7Servicio de Cardiología, Hospital General de Albacete, Albacete, SpainUnidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, SpainUnidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, SpainUnidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, SpainUnidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, SpainServicio de Cardiología, Hospital General de Albacete, Albacete, SpainServicio de Cardiología, Hospital General de Albacete, Albacete, SpainUnidad de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital General de Albacete, Albacete, SpainABSTRACT Introduction and objectives: Today it has become increasingly common to perform procedures without withdrawing oral anticoagulation. However, the need to withdraw oral anticoagulants prior to cardiac catheterization in patients chronically anticoagulated (OACs) remains controversial. We evaluated the efficacy and safety of performing transradial catheterization in outpatients without withdrawing direct-action oral anticoagulants (DOACs). Methods: Prospective and observational study where 270 patients who underwent elective transradial cardiac catheterization were included from January 2013 through November 2017, divided into 3 groups of 90 patients based on their anticoagulant intake: group A (without OAC), with group B (with vitamin K antagonist), and group C (with DOACs), and matched according to the date of completion. In no case was the OAC discontinued before the procedure. We evaluated the complications of radial access within the first 24 h and 1 month after the procedure. Results: The group of patients on DOACs had a higher proportion of men compared to the vitamin K antagonist group (71.1% vs 47.8%; P = .01) and patients were younger in the group without OAC (63.45 ± 11.47 vs 70.22 ± 9.35; P = .03). Group B had a lower percentage of diabetic patients (22.2% vs 36.67% in group C, P = .03). In group A, patients were more prone to having a history of ischemic heart disease compared to the groups of anticoagulated patients (27.84% vs 14.44% in group C, P = .028) in addition to a more frequent intake of antiplatelet drugs. Radial access was the access of choice in most patients (98.2%). There were no significant differences when it comes to vascular access complications among the groups being the rate of hematoma and/or bleeding at discharge equal to 1.1% in the DOACs group and the arterial occlusion rates both at discharge and at 1 month between 0% and 2.2%. Conclusions: In our experience performing transradial diagnostic cardiac catheterizations without discontinuation of DOACs is safe, with low rates of thrombotic and hemorrhagic complications, without any differences with vitamin K antagonist and no OAC.https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=157DOACs NOACs Direct vitamin K anticoagulants Non-vitamin K anticoagulants Cardiac catheterization Transradial |
| spellingShingle | Cristina Ramírez Guijarro Antonio Gutiérrez Díez Juan Gabriel Córdoba Soriano Arsenio Gallardo López Driss Melehi El-Assali Juan José Portero Portaz Javier Navarro Cuartero Jesús Jiménez Mazuecos Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants REC: Interventional Cardiology (English Ed.) DOACs NOACs Direct vitamin K anticoagulants Non-vitamin K anticoagulants Cardiac catheterization Transradial |
| title | Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants |
| title_full | Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants |
| title_fullStr | Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants |
| title_full_unstemmed | Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants |
| title_short | Safety profile of outpatient diagnostic catheterization procedures in patients under direct-acting oral anticoagulants |
| title_sort | safety profile of outpatient diagnostic catheterization procedures in patients under direct acting oral anticoagulants |
| topic | DOACs NOACs Direct vitamin K anticoagulants Non-vitamin K anticoagulants Cardiac catheterization Transradial |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=157 |
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