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Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Direct Oral Anticoagulant Use Early After Cardiac Surgery: A Retrospective Cohort Study.

Jung-Jin Wu1, Jessie Jiang2, Jian Ye3

  • 1Department of Pharmacy, Ridge Meadows Hospital, and Faculty of Pharmaceutical Sciences, Maple Ridge, British Columbia, Canada.

CJC Open
|April 8, 2024
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Summary
This summary is machine-generated.

Direct oral anticoagulants (DOACs) were prescribed to 30% of patients post-cardiac surgery, with no significant differences in bleeding or hospital stay compared to warfarin. This study provides insights into DOAC use in this patient population.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Limited literature exists on direct oral anticoagulant (DOAC) use post-cardiac surgery.
  • Cardiac surgery patients are often excluded from major clinical trials.
  • Guidance for early DOAC prescribing after cardiac surgery is needed.

Purpose of the Study:

  • To compare in-hospital DOAC use versus warfarin early after cardiac surgery.
  • To identify factors associated with DOAC prescribing.
  • To evaluate postoperative length of stay and bleeding events.

Main Methods:

  • Retrospective cohort study of adult patients receiving anticoagulation post-cardiac surgery.
  • Compared patients on DOACs versus warfarin.
  • Excluded patients with DOAC contraindications.

Main Results:

  • 30% of 210 patients received DOACs upon discharge; 70% received warfarin.
  • Apixaban was the most common DOAC; median initiation was postoperative day 5.
  • No significant differences in postoperative length of stay or in-hospital bleeding between groups.

Conclusions:

  • Direct oral anticoagulants (DOACs) are used in about one-third of patients after cardiac surgery.
  • DOAC use was associated with older age, less valvular disease, preoperative DOAC use, and isolated CABG.
  • Bleeding and length of stay did not differ between DOAC and warfarin groups.