Article Text

Download PDFPDF
25 Patients treated with long term warfarin therapy undergoing PCI – complex disease and adverse outcomes
  1. Khaled Yazji,
  2. Sorayya Kakhi,
  3. Nick Ossei-Gerning,
  4. Anirban Choudhury,
  5. Richard Anderson,
  6. Tim Kinnaird
  1. University Hospital of UK


Introduction Patients treated with warfarin who undergo percutaneous coronary intervention (PCI) present a difficult therapeutic problem. Their baseline demographics, procedural characteristics and 12-month outcomes are poorly defined.

Methods We conducted a retrospective analysis of all patients who underwent PCI at a major UK cardiac centre between 2012 and 2013. Of the 2675 patients who underwent PCI, 155 were on long-term warfarin (5.8%). Patients on warfarin were older and more likely to have significant comorbidity than patients not on warfarin.

Results The Mehran bleed scores (19.0 ± 5.8 vs. 15.4 ± 8.0, p = 0.004) and baseline SYNTAX scores (18.5 ± 9.1 vs. 12.4 ± 3.8, p = 0.0006) were higher in patients treated with warfarin vs. those not treated. Bare metal stents were more frequently utilised in warfarin patients than non-warfarin patients (44.8 vs. 26.3%, p < 0.0001) and residual SYNTAX scores were higher (8.3 ± 1.1 vs. 3.8 ± 5.9, p = 0.001). Anti-platelet mono-therapy was prescribed after PCI in 14.4% of warfarin patients and 0.7% of non-warfarin (p < 0.0001) whilst mean DAPT duration was also significantly shorter (4.3 vs. 10.7 months, p < 0.0001). At 1-year follow-up TVR (6.5 vs. 3.3%, p < 0.05), stent thrombosis (5.0 vs. 2.6%, p = 0.14), death (10.1 vs. 4.6%, p < 0.01) and TVR/ST/death (21.6% vs. 10.5%, p = 0.004) were all more common in the warfarin cohort.

Conclusion In conclusion patients treated with warfarin who undergo PCI are a complex cohort and are more likely to receive incomplete revascularisation, less intense and shorter durations of anti-platelet therapy and have adverse 1-year outcomes.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.