Navigation Links
Operating without interrupting warfarin reduces risk of bleeding after cardiac device surgery
Date:5/10/2013

DENVER, May 9, 2013 A new Canadian study shows that operating without interrupting warfarin treatment at the time of cardiac device surgery is safe and markedly reduces the incidence of clinically significant hematomas compared to the current standard of care. The new findings were released today at Heart Rhythm 2013, the Heart Rhythm Society's 34th Annual Scientific Sessions, and will be published online today in The New England Journal of Medicine (NEJM).

At least a quarter of patients that require pacemaker or implantable defibrillator surgery are taking warfarin to reduce the risk of a stroke. Current guidelines recommend bridging many of these patients to heparin treatment and stopping anticoagulation therapy in the days leading up to surgery which can put a patient at risk of a stroke. The Bruise Control trial is the largest randomized clinical trial to compare continuing warfarin to temporary cessation with heparin bridging in patients before and after device surgery.

"We hope that Bruise Control will change how we are treating patients around the world," said lead author David Birnie, MD, Director of the Arrhythmia Service at the University of Ottawa Heart Institute, Canada. "Our study conclusively shows that treating patients with a high risk of stroke with continued warfarin instead of heparin bridging will improve patient outcomes, decrease complications and reduce hospitalization."

Bruise Control randomized 681 patients at 17 Canadian and 1 Brazilian center with a less than 5 percent annual risk of thrombo-embolic events. One group received continued warfarin, while the other patients were bridged to therapeutic doses of either intravenous heparin or subcutaneous low-molecular-weight heparin starting three days before the procedure and resuming 24 hours after surgery. Patients were evaluated after surgery and the study found that clinically significant hematomas were 80 percent less frequent in patients that received uninterrupted warfarin. Compared to the heparin arm of the trial, patients receiving warfarin had fewer prolonged hospital stays (1.2 percent vs. 4.8 percent), less re-interruption of anticoagulation (3.3 percent vs. 14.5 percent) and fewer re-operations (0.6 percent vs. 2.4 percent). Patients in the continued warfarin arm also had greater satisfaction with their peri-operative anticoagulation management.

Co-Principal Investigator Vidal Essebag, MD, PhD, Director of Cardiac Electrophysiology, McGill University Health Center, Montreal, stated, "To many, the substantial reduction in pocket hematoma that we observed with continued warfarin may be counterintuitive. One explanation that has been proposed is the concept of an 'anticoagulant stress test.' That is, if patients undergo surgery while fully anticoagulated, any excessive bleeding will be detectable and appropriately managed while the wound is still open. In contrast, when surgery is performed with heparin bridging, such bleeding may remain latent, and appear only when full anticoagulation is resumed postoperatively."

The Bruise Control trial was funded by the Canadian Institutes of Health Research (CIHR).

"This randomized clinical trial eliminates a dilemma faced by physicians throughout the world," said Dr. Jean Rouleau, Scientific Director of the CIHR Institute of Circulatory and Respiratory Health. "The study shows that patients requiring cardiac arrhythmia device surgery can remain on their current blood thinners, thus reducing the chance of stroke and hematoma. CIHR is pleased to support Dr. Birnie and his team. Our hope is that this research evidence will soon be brought to the point of care, so it can benefit patients around the world."


'/>"/>

Contact: Vincent Lamontagne
vlamontagne@ottawaheart.ca
613-761-4427
University of Ottawa Heart Institute
Source:Eurekalert

Related biology technology :

1. Danai Brooks Joins Dyadic International as Chief Operating Officer
2. Regeneron Reports First Quarter 2013 Financial and Operating Results
3. AFcell Medical Hires Chief Operating Officer
4. - Unigene Secures Financing to Extend Operating Runway in Conjunction with Strategic Reorganization -
5. Cempra, Inc. Reports Fourth Quarter and Full Year 2012 Financial and Operating Results
6. ABIA Hires Biomedical Executive, Serial Entrepreneur as Chief Operating Officer
7. Ampio Pharmaceuticals, Inc. (AMPE) announces appointment of Josh Disbrow as Chief Operating Officer effective December 15, 2012
8. Millions of DNA switches that power human genomes operating system are discovered
9. Preliminary Figures for 2011: Sartorius Grows at Double-Digit Rates and Boosts Operating Earnings by More Than 30%
10. Scott Brooks Joins Regenesis Biomedical as Chief Operating Officer
11. Inovio Pharmaceuticals Promotes Niranjan Sardesai to Chief Operating Officer
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:8/16/2017)... , ... August 16, 2017 , ... ... into a different cell type. Many treatments for specific cancers, such as breast, ... of targeted treatment is androgen deprivation therapy for advanced prostate cancer. , ...
(Date:8/16/2017)... OXFORD, England , Aug. 16, 2017  Kingfisher ... executive search and leadership development, and Virdis Group, global executive ... an exclusive alliance that enables clients to leverage the expertise ... "For our clients here in the Boston ... a diverse population of leadership talent throughout the US, ...
(Date:8/15/2017)... ... ... Any expert in stem cell research or stem cell medicine knows well the ... Despite their essential roles in human health and regenerative medicine, adult tissue stem ... this purpose also tag other, more abundant, non-stem tissue cells ( See 2017 Cell ...
(Date:8/14/2017)... ... August 14, 2017 , ... Every ... Key researchers in the antibody community have recently come together to address this ... in the laboratory. , The team at Thermo Fisher Scientific ...
Breaking Biology Technology:
(Date:3/24/2017)... Mar 24, 2017 Research and Markets has ... Market Analysis & Trends - Industry Forecast to 2025" report ... ... at a CAGR of around 15.1% over the next decade to ... report analyzes the market estimates and forecasts for all the given ...
(Date:3/23/2017)... 2017 Research and Markets has announced the ... Trends - Industry Forecast to 2025" report to their offering. ... The Global ... of around 8.8% over the next decade to reach approximately $14.21 ... market estimates and forecasts for all the given segments on global ...
(Date:3/22/2017)... NEW YORK , March 21, 2017 /PRNewswire/ ... Customer Marketing Cloud used by retailers such as ... in its platform — Product Recommendations and Replenishment. Using ... to give more personalized product and replenishment recommendations ... purchases, but also on predictions of customer intent ...
Breaking Biology News(10 mins):