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COMMENTS AND OPINIONS
Factors in Warfarin Therapy Discontinuation
Christopher John Boos, MBBS, MRCP, MD;
Howard J. Marshall, MBBS, FRCP, MD
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We read with great interest the recent article by Garcia et al,1 which investigated the incidence of periprocedural bleeding (0.6% for major and 1.7% for minor) and thromboembolic complications (0.7%) following short-term interruption of warfarin therapy prior to a variety of outpatient invasive procedures.
While their reported event rates were very low, the authors make no mention of the international normalized ratio levels taken at the time the procedures were performed. This is potentially important because the median duration of warfarin therapy discontinuation in this study was only 3 days. It has been shown that there is still significant residual anticoagulation, even at 3 days, following warfarin therapy discontinuation, particularly among elderly patients.2 The implications of this become even more pertinent when considering more invasive operative procedures, such as cardiac pacing and coronary angiography.
Second, we find it . . . [Full Text of this Article]
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Risk of Thromboembolism With Short-term Interruption of Warfarin Therapy
David A. Garcia, Susan Regan, Lori E. Henault, Ashish Upadhyay, Jaclyn Baker, Mohamed Othman, and Elaine M. Hylek
Arch Intern Med. 2008;168(1):63-69.
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