Guidelines for the perioperative management of anticoagulants and antiplatelet agents (ACCP)

Clinical Question

What is the best way to manage different anticoagulants and antiplatelet drugs for patients undergoing therapy?

Bottom line

This guideline, and its very helpful figures, provides useful guidance for primary care physicians. Unfortunately, only 2 of the recommendations are classified as "strong": the one against the use of LMWH bridging in patients with atrial fibrillation, and the one to continue warfarin in patients undergoing pacemaker or implantable cardioverter-defibrillator placement. There are a lot of subtleties in this guideline, and it is worth consulting, especially for patients at high risk of thrombosis or who are undergoing a high-risk procedure. 1a-

Study design: Practice guideline

Funding: Foundation

Setting: Various (guideline)


Mark H. Ebell, MD, MS
University of Georgia
Athens, GA

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Arup Kumar Dhara

Impact assessment



Post op coag

Constant evolution