The American College of Cardiology held a roundtable Oct. 24 to discuss health care issues and anticoagulation management.
The main focus of the event was to discuss periprocedural management in anticoagulation as well as bleeding management. The goal was to help professionals make informed decisions on health care.
“In the periprocedural setting, it is estimated that 27 percent of patients are being managed by an anticoagulation service and 15 percent by pharmacists, and in the aftercare setting, these percentages are similar at 28 percent and 14 percent, respectively,” Bella Mehta, PharmD, FAPhA, associate professor of clinical pharmacy, Ohio State University, said.
One of the questions that came up during the roundtable was who should perform bridging when it came to making decisions.
“For bridging, the decision should really be made with a group of clinicians, including the operating surgeon, the anticoagulation service and/or prescribing physician or provider and the pharmacist. It should be a team-based approach,” Mehta said.
The roundtable also discussed the recently published trial "Bridging Anti-Coagulation in Patients Who Require Temporary Interruption of Warfarin Therapy for an Elective Procedure or Surgery."
“Most patients in the BRIDGE trial were low risk, with few patients having high CHADS2 scores and most patients undergoing low-risk procedures. Also, the results cannot be applied to patients who have mechanical heart valves,” she said.