1. (p for noninferiority = 0.01)
BRIDGE
Trial design: Patients with atrial fibrillation on warfarin therapy undergoing an invasive procedure were then randomized to placebo injection (n = 950) vs. low molecular weight heparin; dalteparin 100 IU/kg subcutaneous twice daily (n = 934).
Results
(p for noninferiority = 0.01)
Stroke, TIA, or systemic embolism: 0.4% of the no-bridge group vs. 0.3% of the bridging group (p = 0.01 for noninferiority)
Major bleeding: 1.3% vs. 3.2% (p = 0.005), respectively, for no-bridge versus bridge groups %
0.4
0.3
Conclusions
Among patients with atrial fibrillation on warfarin therapy, bridge therapy with low molecular weight heparin did not prevent perioperative arterial thromboembolic events
However, this strategy did increase major bleeding
Low molecular weight heparin bridge
Placebo
Douketis JD, et al. N Engl J Med 2015;373:823-33