title: The management of patients on oral anticoagulation undergoing coronary stent implantation: a survey among interventional cardiologists from eight European countries.
abstract: OBJECTIVE
  To evaluate the current management, and adherence to recommendations, of patients on oral anticoagulation (OAC) undergoing coronary stent implantation (PCI-S).
  
  
  METHODS
  By means of a contact person who had been previously identified in 8 European countries, a questionnaire was electronically forwarded between April and July 2010 to the national institutions where PCI-S is performed.
  
  
  RESULTS
  A total of 202 questionnaires (median response rate: 50%, range 33-78%) was received. The prevalence of OAC patients among those undergoing PCI-S is mostly reported 5-10% (97%). The peri-procedural pharmacological management mostly encompasses: preprocedural OAC interruption and bridging with low-molecular-weight heparin (59%), intraprocedural administration of an unfractionated heparin bolus (81%), and use of glycoprotein IIb/IIIa inhibitors on an individual basis (79%). The radial approach is reported as the preferred option (58%), as well as the implantation of bare metal stents (76%). Triple therapy (warfarin, aspirin, clopidogrel) is the most frequently prescribed (80%), generally for 1 month after bare metal stent (77%) and for at least 12 months after drug-eluting stent (60%). Throughout triple therapy, the International Normalized Ratio is mostly targeted to the lower end of the therapeutic range (77%), and gastric protection is routinely prescribed (69%), mostly by giving proton-pump inhibitors (70%).
  
  
  CONCLUSIONS
  Among the 202 interventional cardiologists from the 8 European countries interviewed, the management of patients on OAC undergoing PCI-S appears variable and only partially adherent to currently available recommendations.
authors.affiliation: Division of Cardiology & Cardiac Catheterization Laboratory, Ospedale Maggiore, Bologna, Italy. andrearubboli@libero.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Rubboli
authors.forename: Willem
authors.initials: W
authors.lastname: Dewilde
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Eric
authors.initials: E
authors.lastname: Eeckhout
authors.forename: Istvàn
authors.initials: I
authors.lastname: Herzfeld
authors.forename: Josè
authors.initials: J
authors.lastname: Valencia
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: K E Juhani
authors.initials: KE
authors.lastname: Airaksinen
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000284:Administration, Oral; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D005060:Europe; D019538:Health Care Surveys; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage; D006801:Humans; D019934:International Normalized Ratio; D010818:Practice Patterns, Physicians'; D011300:Preoperative Care; D015607:Stents; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D000077144:Clopidogrel; D013988:Ticlopidine