The Management of Patients on Oral Anticoagulation Undergoing Coronary Stent Implantation: A Survey among Interventional Cardiologists from Eight European Countries
Article first published online: 26 SEP 2011
©2011, Wiley Periodicals, Inc.
Journal of Interventional Cardiology
Volume 25, Issue 2, pages 163–169, April 2012
How to Cite
RUBBOLI, A., DEWILDE, W., HUBER, K., EECKHOUT, E., HERZFELD, I., VALENCIA, J., WINDECKER, S., AIRAKSINEN, K. E. J. and LIP, G. Y. H. (2012), The Management of Patients on Oral Anticoagulation Undergoing Coronary Stent Implantation: A Survey among Interventional Cardiologists from Eight European Countries. Journal of Interventional Cardiology, 25: 163–169. doi: 10.1111/j.1540-8183.2011.00683.x
- Issue published online: 9 APR 2012
- Article first published online: 26 SEP 2011
Purpose: To evaluate the current management, and adherence to recommendations, of patients on oral anticoagulation (OAC) undergoing coronary stent implantation (PCI-S).
Methods: By means of a contact person who had been previously identified in 8 European countries, a questionnaire was electronically forwarded between April and July 2010 to the national institutions where PCI-S is performed.
Results: A total of 202 questionnaires (median response rate: 50%, range 33–78%) was received. The prevalence of OAC patients among those undergoing PCI-S is mostly reported 5–10% (97%). The peri-procedural pharmacological management mostly encompasses: preprocedural OAC interruption and bridging with low-molecular-weight heparin (59%), intraprocedural administration of an unfractionated heparin bolus (81%), and use of glycoprotein IIb/IIIa inhibitors on an individual basis (79%). The radial approach is reported as the preferred option (58%), as well as the implantation of bare metal stents (76%). Triple therapy (warfarin, aspirin, clopidogrel) is the most frequently prescribed (80%), generally for 1 month after bare metal stent (77%) and for at least 12 months after drug-eluting stent (60%). Throughout triple therapy, the International Normalized Ratio is mostly targeted to the lower end of the therapeutic range (77%), and gastric protection is routinely prescribed (69%), mostly by giving proton-pump inhibitors (70%).
Conclusions: Among the 202 interventional cardiologists from the 8 European countries interviewed, the management of patients on OAC undergoing PCI-S appears variable and only partially adherent to currently available recommendations. (J Interven Cardiol 2012;25:163–169)