For A-Fib Patients, Bridge Therapy May Do More Harm than Good
Patients with atrial fibrillation who discontinued blood thinners prior to elective surgery did not have an increased risk of developing blood clots and had less risk of major bleeding compared to patients who were given a 'bridge" therapy, scientists from the Duke Medicine reported. Findings from the study are published in the New England Journal of Medicine.
The BRIDGE study evaluated 1,884 patients with atrial fibrillation and atrial flutter. About half were given bridge therapy with dalteparin and the other half were given placebo while halting their warfarin therapy for up to 13 days around their elective surgeries. They were followed up for 37 days after their procedures.
Incidence of arterial blood clot In patients who discontinued all blood thinners was 0.4% vs. 0.3% in patients who received the bridge therapy. Significantly less major bleeding events were seen in patients in the non-bridging group vs. those in the bridging group (1.3% vs. 3.2%).
Bridge therapy seemed to increase the risk of major bleeding complications, researchers concluded. However, the study findings should not be generalized to other types of patients on blood thinners since the data is specific to those with atrial fibrillation. Researchers also noted the findings do not cover the newer blood thinners. These results will be considered in the development of guidelines on the management of atrial fibrillation patients who plan to undergo an elective procedure or surgery.
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