To the Editor: The recent position statement by the Warfarin Reversal Consensus Group provides clear and concise guidelines for a number of clinical scenarios related to the use of warfarin. 1 Unfortunately, it makes the general statement about the periprocedural management of warfarin in patients with atrial fibrillation (AF), “clinical experience suggests that bridging therapy is not required” [page 496]. Clinicians caring for patients with large ischaemic stroke in these circumstances may beg to differ.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009.
- 1. Baker RI, Coughlin PB, Gallus AS, et al. Warfarin reversal: consensus guidelines, on behalf of the Australasian Society of Thrombosis and Haemostasis. Med J Aust 2004; 181: 492-497. <eMJA full text>
- 2. Blacker DJ, Wijdicks EF, McClelland RL. Stroke risk in anticoagulated patients with atrial fibrillation undergoing endoscopy. Neurology 2003; 61: 964-968.
- 3. Dunn A, Turpie A. Perioperative management of patients receiving oral anticoagulants: a systematic review. Arch Intern Med 2003; 163: 901-908.
- 4. Kearon C, Hirsh J. Current concepts: management of anticoagulation before and after elective surgery. N Engl J Med 1997; 336: 1506-1511.
- 5. Blacker DJ, Flemming KD, Link MJ, Brown RD. The preoperative cerebrovascular consultation: common cerebrovascular questions before general or cardiac surgery. Mayo Clin Proc 2004; 79: 223-229.