Evidence map›Paper›PMID 34108229›Full record

Trial reportBMJ (Clinical research ed.)2021

Postoperative low molecular weight heparin bridging treatment for patients at high risk of arterial thromboembolism (PERIOP2): double blind randomised controlled trial.

Michael J Kovacs, Philip S Wells, David R Anderson, Alejandro Lazo-Langner, Clive Kearon, Shannon M Bates, Mark Blostein, Susan R Kahn, Sam Schulman, Elham Sabri and 5 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00432796 (A Double Blind Randomized Control Trial of Post-Operative Low Molecular Weight Heparin Bridging Therapy Versus Placebo Bridging Therapy for Patients Who Are at High Risk for Arterial Thromboembolism), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00432796 phase3unknown statusnot on this map

A Double Blind Randomized Control Trial of Post-Operative Low Molecular Weight Heparin Bridging Therapy Versus Placebo Bridging Therapy for Patients Who Are at High Risk for Arterial Thromboembolism (PERIOP 2)

TypeinterventionalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2006 to 2020Enrolled1,473ConditionsStrokeArmsDalteparin, Placebo
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 95 citations in OpenAlex.

  1. Guideline
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  3. Trial
  4. Article
  5. Managing bleeds on anticoagulant therapy: a practical guide for clinicians.European heart journal. Acute cardiovascular care · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 1 country.

Michael J KovacsDepartment of Medicine, Western University, London, ON, Canada michael.kovacs@lhsc.on.ca.ORCID 0000-0001-7246-1584
Philip S WellsDepartment of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
David R AndersonDepartment of Medicine, Dalhousie University, Halifax, NS, Canada.
Alejandro Lazo-LangnerDepartment of Medicine, Western University, London, ON, Canada.
Clive KearonDepartment of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton ON, Canada.
Shannon M BatesDepartment of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton ON, Canada.
Mark BlosteinDepartment of Medicine, McGill University, Montreal, QC, Canada.
Susan R KahnDepartment of Medicine, McGill University, Montreal, QC, Canada.
Sam SchulmanDepartment of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton ON, Canada.
Elham SabriOttawa Hospital Research Institute, Ottawa, ON, Canada.
Susan SolymossDepartment of Medicine, McGill University, Montreal, QC, Canada.
Tim RamsayOttawa Hospital Research Institute, Ottawa, ON, Canada.
Erik YeoDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Marc A RodgerDepartment of Medicine, McGill University, Montreal, QC, Canada.
PERIOP2 Investigators
McGill University · CAThrombosis and Atherosclerosis Research Institute · CAOttawa Hospital · CAWestern University · CADalhousie University · CAUniversity of Ottawa · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the efficacy and safety of dalteparin postoperative bridging treatment versus placebo for patients with atrial fibrillation or mechanical heart valves when warfarin is temporarily interrupted for a planned procedure.

designProspective, double blind, randomised controlled trial.

setting10 thrombosis research sites in Canada and India between February 2007 and March 2016.

participants1471 patients aged 18 years or older with atrial fibrillation or mechanical heart valves who required temporary interruption of warfarin for a procedure.

interventionRandom assignment to dalteparin (n=821; one patient withdrew consent immediately after randomisation) or placebo (n=650) after the procedure.

main outcome measuresMajor thromboembolism (stroke, transient ischaemic attack, proximal deep vein thrombosis, pulmonary embolism, myocardial infarction, peripheral embolism, or vascular death) and major bleeding according to the International Society on Thrombosis and Haemostasis criteria within 90 days of the procedure.

resultsThe rate of major thromboembolism within 90 days was 1.2% (eight events in 650 patients) for placebo and 1.0% (eight events in 820 patients) for dalteparin (P=0.64, risk difference -0.3%, 95% confidence interval -1.3 to 0.8). The rate of major bleeding was 2.0% (13 events in 650 patients) for placebo and 1.3% (11 events in 820 patients) for dalteparin (P=0.32, risk difference -0.7, 95% confidence interval -2.0 to 0.7). The results were consistent for the atrial fibrillation and mechanical heart valves groups.

conclusionsIn patients with atrial fibrillation or mechanical heart valves who had warfarin interrupted for a procedure, no significant benefit was found for postoperative dalteparin bridging to prevent major thromboembolism.

trial registrationClinicaltrials.gov NCT00432796.

Indexed as

Surgical Procedures, OperativeAgedAged, 80 and overAnticoagulantsAtrial FibrillationDalteparinDouble-Blind MethodFemaleHeart Valve ProsthesisHumansMaleMiddle AgedPostoperative PeriodProspective StudiesThromboembolismWarfarinAnticoagulantsDalteparinWarfarin

Identifiers

PMID34108229
PMCPMC8188228
OpenAlexW3172115124

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.