CHEST Perioperative Guidelines for Antithrombotic Therapy

New recommendations guide management of perioperative and periprocedural antithrombotic agents.

Sponsoring Organization: American College of Chest Physicians (ACCP)

Background

In their previous guideline on perioperative antithrombotic management (published a decade ago; Chest 2012;141:2 Suppl:e326S), the ACCP addressed 11 questions; now, they discuss 43 questions, using a structured approach. All recommendations are for perioperative patients who are undergoing elective surgery or procedures.

Key Recommendations

1. In patients who are receiving vitamin K antagonists (VKAs, e.g., warfarin) and who require VKA interruption prior to surgery:

Stop VKAs ≥5 days prior to surgery, and restart VKAs <24 hours following surgery.
Do not provide routine heparin bridging for patients who are receiving VKAs for atrial fibrillation, venous thromboembolis…

Reviewing Author

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)