Heparin Bridging in Anticoagulated Patients: Overused and Possibly Hazardous

In the prospective ORBIT-AF registry, bridging for AF patients during interrupted chronic anticoagulation was associated with increased risk for bleeding and no stroke-prevention benefit.

Although guidelines exist for use of bridging anticoagulation during short-term interruptions of warfarin in patients with atrial fibrillation, they are based largely on expert opinion. Researchers have now examined the effects of bridging in ORBIT-AF, a prospective, community-based registry of patients with AF. In this registry, 7372 patients were on chronic anticoagulation (AC), of whom 2200 patients underwent 2803 interruptions of AC for medical procedures. ORBIT-AF is sponsored by an anticoagulant manufacturer.

Most interrupted treatments were warfarin (96%); only 4% were dabigatran. During interruptions, bridging anticoagulants were used in 24% (low-molecular-weight heparin in 73% and unfractionated heparin in 15%). As expected, signifi…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Heparin Bridging in Anticoagulated Patients: Overused and Possibly Hazardous

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Reviewing Author