PMID- 17631677
OWN - NLM
STAT- MEDLINE
DCOM- 20071128
LR  - 20080317
IS  - 1365-2168 (Electronic)
IS  - 0007-1323 (Linking)
VI  - 94
IP  - 11
DP  - 2007 Nov
TI  - Prevention of perioperative thromboembolism in patients with atrial fibrillation.
PG  - 1351-5
AB  - BACKGROUND: The aim of this retrospective study was to review the safety and 
      efficacy of two regimens for the prophylaxis of perioperative thromboembolism in 
      patients with atrial fibrillation. METHODS: From a database of 14 801 procedures, 
      atrial fibrillation occurred in 1.9 per cent of patients. Those not on oral 
      anticoagulation (n = 146) received low molecular weight heparin (LMWH) before and 
      after surgery (nadroparine 40 units per kg). Patients on oral anticoagulation 
      before surgery (n = 136) received intravenous unfractionated heparin (UFH) after 
      surgery at a dose adequate to maintain the thrombin time at a therapeutic level. 
      RESULTS: The incidence of perioperative arterial or venous thromboembolism was 
      independent of pre-existing risk factors and occurred in 4.6 per cent of 
      patients, without significant difference between the two regimens (P = 0.780). 
      Logistic regression revealed that thromboembolism was significantly associated 
      with increased perioperative mortality (odds ratio 9.5, (95 per cent confidence 
      interval 2.5 to 35.8); P = 0.001). The rate of postoperative bleeding was 4.8 per 
      cent in patients who had LMWH and 17.6 per cent in those who had UFH (P < 0.001). 
      CONCLUSION: Postoperative anticoagulation with therapeutic UFH in patients with 
      atrial fibrillation was associated with an increased rate of bleeding without 
      reducing the risk of thromboembolism.
CI  - Copyright (c) 2007 British Journal of Surgery Society Ltd.
FAU - Beldi, G
AU  - Beldi G
AD  - Department of Visceral and Transplant Surgery, University Hospital Berne, 
      Inselspital, Berne, Switzerland. guido.beldi@insel.ch
FAU - Beng, L
AU  - Beng L
FAU - Siegel, G
AU  - Siegel G
FAU - Bisch-Knaden, S
AU  - Bisch-Knaden S
FAU - Candinas, D
AU  - Candinas D
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br J Surg
JT  - The British journal of surgery
JID - 0372553
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
CIN - Br J Surg. 2008 Mar;95(3):399; author reply 400. PMID: 18278791
CIN - Br J Surg. 2008 Mar;95(3):399-400; author reply 400. PMID: 18278793
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/therapeutic use
MH  - Atrial Fibrillation/*complications
MH  - Blood Loss, Surgical
MH  - Blood Transfusion
MH  - Female
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Intraoperative Complications/*prevention & control
MH  - Male
MH  - Middle Aged
MH  - Postoperative Care
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thromboembolism/*prevention & control
MH  - Treatment Outcome
EDAT- 2007/07/17 09:00
MHDA- 2007/12/06 09:00
CRDT- 2007/07/17 09:00
PHST- 2007/07/17 09:00 [pubmed]
PHST- 2007/12/06 09:00 [medline]
PHST- 2007/07/17 09:00 [entrez]
AID - 10.1002/bjs.5835 [doi]
PST - ppublish
SO  - Br J Surg. 2007 Nov;94(11):1351-5. doi: 10.1002/bjs.5835.