Warfarin is safe for patients getting cardiac devices

Findings from the trial run counter to current guidelines for patients getting pacemakers or defibrillators to stabilize their heart rhythm.

A recent randomized controlled trial has found that patients continuing to take the blood thinner warfarin are 80 per cent less likely to develop significant bleeding after cardiac device surgery than patients who are switched to heparin – another type of blood thinner. These medications are used to prevent strokes caused by the formation of blood clots after surgery and the trial was designed to test the safety of the two anti-coagulants.  

Findings from the trial run counter to current guidelines for patients getting pacemakers or defibrillators to stabilize their heart rhythm. Heparin was considered to have less serious side effects, and therefore safer for patients undergoing surgery.

The study was co-lead by VCH Research Institute clinical researcher, Dr. Andrew Krahn, Head of the VGH Pacemaker Clinic and Head of the Division of Cardiology, UBC Faculty of Medicine and results were published May 9 in the New England Journal of Medicine.

The study randomly assigned 681 patients undergoing implantable cardiac device surgery in Canada and Brazil to either continued doses of warfarin or warfarin discontinued before surgery with transition to heparin injections. Patients receiving warfarin experienced less bleeding overall and subsequently had fewer prolonged hospitalizations and re-operations.

“This makes things much simpler for patients,” says Dr. Krahn. “They just remain on their usual blood thinner pills instead of switching to painful, expensive injections around the time of their surgery.”

The team’s hope is that this research evidence will soon be brought to the point of care so it can benefit patients around the world.

 

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