Warfarin: Impact on hemostasis after radial catheterization.
OBJECTIVE
This study explores bleeding risk of warfarin patients undergoing radial catheterization.


BACKGROUND
Traditionally warfarin has been held prior to catheterization due to bleeding risk; however, this practice is being reconsidered with radial access. This study examined if radial patients receiving warfarin have similar hemostasis times to those not taking warfarin.


METHODS
A convenience sample of patients undergoing radial catheterization was analyzed. Demographics, procedure characteristics, and pharmacologic therapies were reviewed. Hemostasis times, defined as compression band times, were compared. To exclude confounding effects of aspirin and clopidogrel, a separate analysis of band times for each medication was performed. Specifically, analysis of variance models and exact logistic regression models were used to assess means between usage or nonusage of medications (warfarin, aspirin, clopidogrel) while adjusting for other medications.


RESULTS
Of 208 patients, 60 (29%) were taking warfarin. The breakdown of warfarin, aspirin, and clopidogrel use was as follows: 6 (3%) not taking medications; 14 (7%) warfarin alone; 88 (42%) aspirin alone; 2 (1%) clopidogrel alone; 39 (19%) both warfarin and aspirin; 52 (25%) clopidogrel and aspirin; and 7 (3%) warfarin, aspirin, and clopidogrel. No major complications occurred. Mean hemostasis times for warfarin and nonwarfarin patients were not different (118 vs. 116 min; P = 0.25). Likewise, there was no difference for aspirin (117 vs. 114 min; P = 0.70). There was a nonsignificant trend toward clopidogrel prolonging hemostasis (123 vs. 114 min; P = 0.09).


CONCLUSIONS
There were no apparent differences in adequacy of hemostasis or duration of compression time between patients taking warfarin or not taking warfarin after controlling for antiplatelet therapy. © 2014 Wiley Periodicals, Inc.
Penn State University College of Medicine, Hershey, Pennsylvania.
Christina M
CM
Lippe
Elizabeth A
EA
Reineck
Allen R
AR
Kunselman
Ian C
IC
Gilchrist
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D000077144:Clopidogrel; D016208:Databases, Factual; D004334:Drug Administration Schedule; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D006487:Hemostasis / Q000187:drug effects*; D006489:Hemostatic Techniques; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D017534:Radial Artery; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
anti-coagulants/anti-thrombins; anti-platelet therapy; bleeding; catheterization; complications; diagnostic catheterization; radial