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Perioperative bridging anticoagulation for atrial fibrillation-the first
randomised controlled trial
#MMPMID27280017
Wight JM
; Columb MO
Perioper Med (Lond)
2016[]; 5
(?): 14
PMID27280017
show ga
ABSTRACT: Patients who have atrial fibrillation (AF) have increased
thromboembolic risk. This risk is mitigated through use of anticoagulants,
traditionally with vitamin K antagonists such as warfarin, and more recently with
drugs such as Xa and thrombin inhibitors. Since anticoagulants increase the risk
of bleeding, uncertainty exists regarding their use in the perioperative period.
The risk of thromboembolism for each patient must be balanced against risk of
bleeding; anticoagulation medication may be continued, replaced with a
short-acting alternative or withheld entirely. Until recently, evidence on best
management relied on expert opinion and observational studies. The recent
publication of a randomised, double-blind, placebo-controlled trial (BRIDGE) has
added important information to the knowledge base. TRIAL REGISTRATION: BRIDGE
ClinicalTrials.gov, NCT00786474.