Chest
Anticoagulation: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery
Section snippets
Summary
While the risk for atrial thrombus formation and stroke must be considered, the potential major complications of postoperative AF and AFL, anticoagulation must be considered in light of the complex alterations of coagulation and the risk for enhanced bleeding tendency associated with cardiac surgery and cardiopulmonary bypass. Thus, the relative merits of anticoagulation therapy in patients with AF after cardiac surgery must be weighed against (1) the potential risk for bleeding in a setting of
Summary of Recommendations
- 1.
In optimally selected patients with chronic AF and in those patients in whom it is thought to be likely that AF will continue postoperatively, we recommend anticoagulation therapy (strength of recommendation, A; evidence grade, good; net benefit, substantial).
- 2.
In the high-risk patient with postoperative AF, such as those with a history of stroke or transient ischemic attack, the routine use of heparin should be considered (strength of recommendation, C; evidence grade, low; net benefit,
References (19)
- et al.
Effect of ticlopidine on saphenous vein bypass patency rates: a double-blind study
Ann Thorac Surg
(1984) - et al.
Improved aortocoronary bypass patency by low-dose aspirin (100 mg daily): effects on platelet aggregation and thromboxane formation
Lancet
(1984) - et al.
Implications of preoperative administration of aspirin in patients undergoing coronary artery bypass grafting: Department of Veterans Affairs Cooperative Study on Antiplatelet Therapy
J Am Coll Cardiol
(1990) - et al.
Dipyridamole for coronary artery bypass surgery
Thromb Res
(1990) - et al.
Prevention of one-year vein-graft occlusion after aortocoronary-bypass surgery: a comparison of low-dose aspirin, low-dose aspirin plus dipyridamole, and oral anticoagulants: the CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands
Lancet
(1993) - et al.
Assessment of three schemes of stratifying stroke risk in patients with nonvalvular atrial fibrillation
Am J Med
(2000) - et al.
Clinical observations with the amiodarone/warfarin interaction: dosing relationship with long-term therapy
Chest
(2002) - et al.
Failure of antiplatelet and anticoagulant therapy to improve patency of grafts after coronary-artery bypass: a controlled, randomized study
N Engl J Med
(1979) - et al.
A platelet-inhibitor-drug trial in coronary-artery bypass operations: benefit of perioperative dipyridamole and aspirin therapy on early postoperative vein-graft patency
N Engl J Med
(1982)
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