Perioperative Bridging Anticoagulation Unhelpful for Invasive Procedures.

Bottom Line Bridging anticoagulation worsens outcomes for patients with atrial fibrillation who undergo an elective invasive procedure, resulting in more episodes of major bleeding and no difference in the rate of stroke or venous thromboembolism. Most of the patients in the study had a CHADS2 score of 1 (23%), 2 (40%), 3 (24%), or 4 (10%). The patients were largely undergoing minor surgical procedures with low bleeding risk, and patients at very high risk of thromboembolism or stroke were not represented in this study. (Level of Evidence = 1b)