ArticleJournal of thrombosis and haemostasis : JTH2022
Outcomes in patients undergoing periprocedural interruption of warfarin or direct oral anticoagulants.
Article in Journal of thrombosis and haemostasis : JTH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06957366 (Perioperative Anticoagulant Use for Surgery Evaluation -2), which is not on this map. Cited by 5 papers.
What it found
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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.
Perioperative Anticoagulant Use for Surgery Evaluation -2 (PAUSE-2) Study Patients Receiving a Direct Oral Anticoagulant (DOACs-Dabigatran, Rivaroxaban, Apixaban or Edoxaban) and Needing Elective High-Bleed-Risk Surgery or an Invasive Procedure: A Randomized Control Trial
Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- The incidence and associated factors of pulmonary embolism after cardiac surgery: A retrospective nationwide inpatient sample database study.American heart journal plus : cardiology research and practice · 2026Article
- Perioperative management of colorectal surgical patients receiving a direct oral anticoagulant: a scoping review, particular emphasis on procedure-specific risks, and pharmacogenomics.Frontiers in cardiovascular medicine · 2026Review
- The Type of Preoperative Oral Antithrombotics as a Risk Factor for Venous Thromboembolism After Hip Surgery: A Retrospective Study.Medicina (Kaunas, Lithuania) · 2025Article
- The bridging conundrum: perioperative management of direct oral anticoagulants for venous thromboembolism.Journal of thrombosis and haemostasis : JTH · 2023Review
- Outcomes in patients undergoing periprocedural interruption of warfarin or direct oral anticoagulants.Journal of thrombosis and haemostasis : JTH · 2022Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferences in clinical outcomes following a temporary interruption of warfarin or a direct oral anticoagulant (DOAC) for a surgical procedure are not well described. Differences in patient characteristics from practice-based cohorts have not typically been accounted for in prior analyses.
aimTo describe risk-adjusted differences in postoperative outcomes following an interruption of warfarin vs DOACs.
methodsPatients receiving care at six anticoagulation clinics participating in the Michigan Anticoagulation Quality Improvement Initiative were included if they had at least one oral anticoagulant interruption for a procedure. Inverse probability of treatment weighting (IPTW) was used to balance baseline differences between the warfarin cohort and DOAC cohort. Bleeding and thromboembolic events within 30 days following the procedure were compared between the IPTW cohorts using the Poisson distribution test.
resultsA total of 525 DOAC patients were matched with 1323 warfarin patients, of which 923 were nonbridged warfarin patients and 400 were bridged warfarin patients. The occurrence of postoperative minor bleeding (10.8% vs. 4.7%, p < .001), major bleeding (2.9% vs. 1.1%, p = .01) and clinically relevant nonmajor bleeding (CRNMB) (6.5% vs. 3.0%, p = .002) was greater in the DOAC cohort compared with the nonbridged warfarin cohort. The rates of postoperative bleeding outcomes were similar between the DOAC and the bridged warfarin cohorts.
conclusionPerioperative interruption of DOACs, compared with warfarin without bridging, is associated with a higher incidence of 30-day minor bleeds, major bleeds, and CRNMBs. Further research investigating the perioperative outcomes of these two classes of anticoagulants is warranted.
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