theMednet - In patients with concurrent, CAD and atrial fibrillation, more than 1 year post-PCI, the most recent AHA/ACC guidelines state that “oral anticoagulation monotherapy is recommended over the continuation of oral anticoagulant therapy and a single antiplatelet therapy.” If this individual undergoes surgery, the anticoagulant will be held. Would you then bridge with aspirin?

Topics: Cardiology • Cardiac Electrophysiology

In patients with concurrent, CAD and atrial fibrillation, more than 1 year post-PCI, the most recent AHA/ACC guidelines state that “oral anticoagulation monotherapy is recommended over the continuation of oral anticoagulant therapy and a single antiplatelet therapy.” If this individual undergoes surgery, the anticoagulant will be held. Would you then bridge with aspirin?

Joglar et al., PMID 38033089

Answer from: at Community Practice

This depends on the surgery and for how long anti-coagulation needs to be held. For example, if the patient is undergoing CABG, then the answer is yes, and aspirin seems reasonable. But for some surgeries, all 3 drugs would need to be held (ophtho or some neurosurgical/spinal procedures for example)...

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