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Comment & Response
February 2020

Epidural Catheter Use and Further Issues in Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant

Author Affiliations
  • 1Coagulation Service and Thrombosis Research Unit, San Raffaele Scientific Institute, Milano, Italy
JAMA Intern Med. 2020;180(2):332-333. doi:10.1001/jamainternmed.2019.5864

To the Editor In 240 BC, and just by using shadows and his brain, Eratosthenes, an ancient Greek scientist, calculated the circumference of the Earth with an approximation of less than 0.1%. Such ingenuity cannot be found in the recently published study by Douketis and colleagues.1 The authors’ conclusions are that a simple, standardized perioperative management strategy without heparin bridging or measurement of coagulation function is associated with low rates of major bleeding and arterial thrombosis. However, the data presented do not appear to support these conclusions.

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