A recent trial found that among patients with atrial fibrillation (AF) who stopped taking warfarin before undergoing an elective surgery or invasive procedure, forgoing bridging anticoagulation was noninferior to perioperative bridging with low-molecular-weight heparin to prevent arterial thromboembolism. Bridging also nearly tripled the risk of major bleeding without providing benefit in preventing myocardial infarction, venous thromboembolism, or death when compared with no bridging (Douketis JD et al. N Engl J Med. doi:10.1056/NEJMoa1501035 [published online June 22, 2015]).
Slomski A. Bridging Anticoagulation Offers No Perioperative Benefit. JAMA. 2015;314(8):762. doi:10.1001/jama.2015.9951