Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure

Nicolas W Shammas,1,2 Gail A Shammas,1 Susan Jones-Miller,1,2 Mileah Rose Gumpert,1 Miranda Jade Gumpert,1 Christine Harb,1 Majid Z Chammas,1 W John Shammas,1 Rommy A Khalafallah,1 Amy Barzgari,1 Bassel Bou Dargham,1 Ghassan E Daher,1 Rayan Jo Rachwan,1 Andrew N Shammas1 1Midwest Cardiovascular Res...

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Autores principales:	Shammas NW, Shammas GA, Jones-Miller S, Gumpert MR, Gumpert MJ, Harb C, Chammas MZ, Shammas WJ, Khalafallah RA, Barzgari A, Bou Dargham B, Daher GE, Rachwan RJ, Shammas AN
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Access site Common Femoral Artery Complications Oral anticoagulant Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/ed3559ea127342dcaeac0d716a8c1f00
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spelling	oai:doaj.org-article:ed3559ea127342dcaeac0d716a8c1f002021-12-02T11:02:47ZPredictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure1178-203Xhttps://doaj.org/article/ed3559ea127342dcaeac0d716a8c1f002017-03-01T00:00:00Zhttps://www.dovepress.com/predictors-of-common-femoral-artery-access-site-complications-in-patie-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XNicolas W Shammas,1,2 Gail A Shammas,1 Susan Jones-Miller,1,2 Mileah Rose Gumpert,1 Miranda Jade Gumpert,1 Christine Harb,1 Majid Z Chammas,1 W John Shammas,1 Rommy A Khalafallah,1 Amy Barzgari,1 Bassel Bou Dargham,1 Ghassan E Daher,1 Rayan Jo Rachwan,1 Andrew N Shammas1 1Midwest Cardiovascular Research Foundation, 2Cardiology Division, Genesis Heart Institute, Davenport, IA, USA Background: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure.Methods: We retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure.Results: A total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500).Conclusion: Patients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure. Keywords: access site, common femoral artery, complications, oral anticoagulantShammas NWShammas GAJones-Miller SGumpert MRGumpert MJHarb CChammas MZShammas WJKhalafallah RABarzgari ABou Dargham BDaher GERachwan RJShammas ANDove Medical PressarticleAccess siteCommon Femoral ArteryComplicationsOral anticoagulantTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 13, Pp 401-406 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Access site Common Femoral Artery Complications Oral anticoagulant Therapeutics. Pharmacology RM1-950
spellingShingle	Access site Common Femoral Artery Complications Oral anticoagulant Therapeutics. Pharmacology RM1-950 Shammas NW Shammas GA Jones-Miller S Gumpert MR Gumpert MJ Harb C Chammas MZ Shammas WJ Khalafallah RA Barzgari A Bou Dargham B Daher GE Rachwan RJ Shammas AN Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
description	Nicolas W Shammas,1,2 Gail A Shammas,1 Susan Jones-Miller,1,2 Mileah Rose Gumpert,1 Miranda Jade Gumpert,1 Christine Harb,1 Majid Z Chammas,1 W John Shammas,1 Rommy A Khalafallah,1 Amy Barzgari,1 Bassel Bou Dargham,1 Ghassan E Daher,1 Rayan Jo Rachwan,1 Andrew N Shammas1 1Midwest Cardiovascular Research Foundation, 2Cardiology Division, Genesis Heart Institute, Davenport, IA, USA Background: It is unclear whether patients on oral anticoagulants (OAC) undergoing a procedure using common femoral artery access have higher adverse events when compared to patients who are not anticoagulated at the time of the procedure.Methods: We retrospectively reviewed data from consecutive patients who underwent a cardiac procedure at a tertiary medical center. Patients were considered (group A) fully or partially anticoagulated if they had an international normalized ratio (INR) ≥1.6 on the day of the procedure or were on warfarin or new OAC within 48 h and 24 h of the procedure, respectively. The nonanticoagulated group (group B) had an INR <1.6 or had stopped their warfarin and new OAC >48 h and >24 h preprocedure, respectively. The index primary end point of the study was defined as the composite end point of major bleeding, vascular complications, or cardiovascular-related death during index hospitalization. The 30-day primary end point was defined as the occurrence of the index primary end point and up to 30 days postprocedure.Results: A total of 779 patients were included in this study. Of these patients, 27 (3.5%) patients were in group A. The index primary end point was met in 11/779 (1.4%) patients. The 30-day primary composite end point was met in 18/779 (2.3%) patients. There was no difference in the primary end point at index between group A (1/27 [3.7%]) and group B (10/752 [1.3%]; P=0.3155) and no difference in the 30-day primary composite end point between group A (2/27 [7.4%]) and group B (16/752 [2.1%]; P=0.1313). Multivariable analysis showed that a low creatinine clearance (odds ratio [OR] =0.56; P=0.0200) and underweight patients (<60 kg; OR =3.94; P=0.0300) were independent predictors of the 30-day primary composite end point but not oral anticoagulation (P=0.1500).Conclusion: Patients on OAC did not have higher 30-day major adverse events than those who were not anticoagulated at index procedure. Keywords: access site, common femoral artery, complications, oral anticoagulant
format	article
author	Shammas NW Shammas GA Jones-Miller S Gumpert MR Gumpert MJ Harb C Chammas MZ Shammas WJ Khalafallah RA Barzgari A Bou Dargham B Daher GE Rachwan RJ Shammas AN
author_facet	Shammas NW Shammas GA Jones-Miller S Gumpert MR Gumpert MJ Harb C Chammas MZ Shammas WJ Khalafallah RA Barzgari A Bou Dargham B Daher GE Rachwan RJ Shammas AN
author_sort	Shammas NW
title	Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
title_short	Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
title_full	Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
title_fullStr	Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
title_full_unstemmed	Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
title_sort	predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/ed3559ea127342dcaeac0d716a8c1f00
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Predictors of common femoral artery access site complications in patients on oral anticoagulants and undergoing a coronary procedure

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