To Bridge or Not to Bridge: Modelling Periprocedural Anticoagulation Managementvan der Pol, S., Jacobs, M., Meijer, K., Piersma-Wichers, M. G., Tieleman, RG., Postma, M. & van Hulst, M., 3-Aug-2018, p. E417. 1 p.
Research output: Contribution to conference › Poster › Academic
Method(s): A probabilistic Markov model was developed to simulate both a bridge and a non-bridge cohort of AF patients periprocedurally. Modelled events were based on the clinically used CHA2DS2-VASc and HAS-BLED stroke and bleeding prediction rules. To predict strokes, INR values were considered. Quality-adjusted life expectancy, based on the beforementioned clinical endpoints, was the main outcome considered.
Result(s): The base case analysis shows that bridging anticoagulation increases the bleeding rate, but reduces the stroke rate. Bridging may be beneficial for patients with a CHA2DS2-VASc scores of 6 or higher and HAS-BLED scores of 0 to 2. For expected shorter periods to reach therapeutic INR, bridging therapy is less likely to be beneficial.
Conclusion(s): For patients at high risk of bleeding, bridging anticoagulation Is not likely to be beneficial. For patients at high risk of stroke and low risk of bleeding, bridging anticoagulation may result in additional quality adjusted life years. INR management is an important factor to consider periprocedurally when making the decision whether to bridge.
|Number of pages||1|
|Publication status||Published - 3-Aug-2018|
|Event||17th Biennial European Meeting of the Society for Medical Decision Making - Leiden, Netherlands|
Duration: 10-Jun-2018 → 12-Jun-2018
|Conference||17th Biennial European Meeting of the Society for Medical Decision Making|
|Period||10/06/2018 → 12/06/2018|
17th Biennial European Meeting of the Society for Medical Decision Making
10/06/2018 → 12/06/2018Leiden, Netherlands
Perioperative Bridging of Vitamin K Antagonist Treatment in Patients with Atrial Fibrillation: Only a Very Small Group of Patients Benefitsvan der Pol, S., Jacobs, M. S., Meijer, K., Piersma-Wichers, M. G., Tieleman, R. G., Postma, M. J. & van Hulst, M., 1-May-2019, In : Europace. 21, 5, p. 716–723 8 p., 308.
Research output: Contribution to journal › Article › Academic › peer-review