PubHawk
N Engl J Med August 2015 PMID 26095867

Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation.

James D Douketis, Alex C Spyropoulos, Scott Kaatz, Richard C Becker, Joseph A Caprini, Andrew S Dunn, David A Garcia, Alan Jacobson, Amir K Jaffer, David F Kong, Sam Schulman, Alexander G G Turpie, Vic Hasselblad, Thomas L Ortel

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Mentions

149
Peak: 16 in Jul 2023
across 5 sources since Aug 2015

Extended reach

369,419
potential audience

Total likes

637

Video views

33,738

Mentions per month

Aug 2015 – May 2025

Where it's discussed

  • X / Twitter69 posts
  • Facebook62 posts
  • News8 articles
  • Blogs8 articles
  • YouTube2 videos

AI synopsis

What people are saying

The overall tone shows a strong consensus supporting the trial's conclusion that avoiding routine bridging is safer for patients with atrial fibrillation, with posts using words like 'proven harmful' and 'confirmation of the evidence.' Several discussions reference how the study has changed or reinforced clinical practices, indicating high engagement and perceived impact in the medical community.

AgreementStrong agreement

Most discussions endorse the findings of the BRIDGE trial, emphasizing the safety and benefits of not using bridging anticoagulation.

InterestHigh interest

Multiple posts express high interest, referencing related studies and clinical implications with enthusiasm and detailed commentary.

EngagementHigh engagement

Many discussions delve into methodological details, implications for practice, and references to specific trials, indicating deep engagement.

ImpactHigh impact

The discussions highlight the significant shift in clinical practice suggested by the trial, with some posts noting how it influences guidelines and treatment strategies.

Abstract in brief

  • The study tested whether skipping bridging anticoagulation is just as safe (noninferior) to using low-molecular-weight heparin to prevent blood clots and whether it results in fewer serious bleeding events (superior).
  • The trial involved over 1800 patients, comparing those who received bridging therapy with dalteparin to those who did not, stopping warfarin 5 days before their procedure and restarting it afterward.
  • The results showed that not using bridging anticoagulation did not increase the risk of blood clots and significantly reduced the chance of major bleeding compared to bridging therapy.
Read the full abstract

Top posts

Most liked on X and Bluesky
David J. Cohen, MD, MSc
@djc795 · X

@emily_fri Bridging has been proven harmful in stable patients. Hard to imagine it is less harmful in critically ill patients. Hippocratic oath applies. https://t.co/jfLawIzZ1V

Jul 13, 2023 · 43 likes · 3 shares · 19,079 followers View post →
Dr. FEVI
@javier20ch · X

Jul 17, 2023 · 35 likes · 10 shares · 13,725 followers View post →
Bloodman
@Bloodman · X

Consult article day 5 - stop bridging people!!

Apr 30, 2021 · 24 likes · 8 shares · 6,433 followers View post →
Ezra Teitelbaum
@EzraTeitelbaum · X

@michael22joseph Whether to bridge perioperatively is a separate question. Fortunately DOACs have made this a lot simpler. Here’s some ammo for your perspective for patients on warfarin… https://t.co/qBCHUy4cxI

Jul 25, 2023 · 22 likes · 1 share · 2,885 followers View post →
Yoichiro.S@循環器内科医
@cardio_dr_ys · X

ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170869 ref.2 Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. NEJM2015; 373: 823–833. PMID: 26095867

Oct 11, 2022 · 18 likes · 6 shares · 3,475 followers View post →
澤野豊明(Toyoaki Sawano)|外科医
@Toyoakisawano · X

参考文献 https://t.co/iU182pYx7H

Apr 3, 2019 · 12 likes · 4,230 followers View post →

All mentions

MARY Aurélien
@MARYau_MCU_PH · X

4/7. En période courte, les chirurgiens ont bien réévalué la question. Ils ne faut pas bridger l'AOD pour une héparine ! L'HBPM : un pavé de l'enfer dans les soins? https://t.co/P5eowVRBAe https://t.co/QikyqLqvoE.

May 20, 2025 · 1,444 followers View post →
Tom Hsiung
@TomHsiung · X

Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation | New England Journal of Medicine https://t.co/8ETPSztvGF

May 9, 2025 · 468 followers View post →
ちろ剤師
@Toki_nd2525 · X

https://t.co/UiZQ25pWqm

Mar 20, 2024 · 1 like · 5,797 followers View post →
Dr. A. Murshid الدكتور/ عبدالإله عبدالرحمن مرشد
@murshid_eyad2 · X

RT @PharmacyToDose: #TrialOfTheDay for August 9th is the BRIDGE trial, published in August 2015 in @NEJM A less is more approach to antic…

Aug 10, 2023 · 2 shares · 5,080 followers View post →
Chidambara .ML.
@chidambara09 · X

RT @PharmacyToDose: #TrialOfTheDay for August 9th is the BRIDGE trial, published in August 2015 in @NEJM A less is more approach to antic…

Aug 9, 2023 · 2 shares · 11,680 followers View post →
Pharmacy To Dose: The Critical Care Podcast
@PharmacyToDose · X

#TrialOfTheDay for August 9th is the BRIDGE trial, published in August 2015 in @NEJM A less is more approach to anticoagulation Open-access article link: https://t.co/5lLYFqPn83 #pharmicu #cardiotwitter #twitterx #medtwitter #foamcc #meded #anticoagulation #some https://t.co/zgqgBOD0sG

Aug 9, 2023 · 2 likes · 2 shares · 6,838 followers View post →
Mina H. Michael, MD
@MinaHMichael · X

RT @EzraTeitelbaum: @michael22joseph Whether to bridge perioperatively is a separate question. Fortunately DOACs have made this a lot simpl…

Jul 25, 2023 · 1 share · 78 followers View post →
Ezra Teitelbaum
@EzraTeitelbaum · X

@michael22joseph Whether to bridge perioperatively is a separate question. Fortunately DOACs have made this a lot simpler. Here’s some ammo for your perspective for patients on warfarin… https://t.co/qBCHUy4cxI

Jul 25, 2023 · 22 likes · 1 share · 2,885 followers View post →
Faby G.
@Fabiolaghh · X

RT @javier20ch:

Jul 24, 2023 · 10 shares · 410 followers View post →
luismi azogil
@luismiazogil · X

RT @javier20ch:

Jul 21, 2023 · 10 shares · 141 followers View post →
dr. lopez
@dr_LopezQ · X

RT @javier20ch:

Jul 19, 2023 · 10 shares · 33 followers View post →
Dr Pakyto
@DPakyto · X

RT @javier20ch:

Jul 18, 2023 · 10 shares · 129 followers View post →
Nela
@EscalonaTM · X

RT @javier20ch:

Jul 18, 2023 · 10 shares · 174 followers View post →
CARLOS SILVA GANDUR
@carsigan · X

RT @javier20ch:

Jul 18, 2023 · 10 shares · 222 followers View post →
Dr. Mcx
@morjcx · X

RT @javier20ch:

Jul 18, 2023 · 10 shares · 477 followers View post →
Eduardo
@Eduardo42937195 · X

RT @javier20ch:

Jul 17, 2023 · 10 shares · 180 followers View post →
Dr. FEVI
@javier20ch · X

Jul 17, 2023 · 35 likes · 10 shares · 13,725 followers View post →
Frederick Berro Rivera, MD
@FredRiveraMD · X

RT @djc795: @emily_fri Bridging has been proven harmful in stable patients. Hard to imagine it is less harmful in critically ill patients…

Jul 14, 2023 · 3 shares · 855 followers View post →
Anju Bhardwaj MD FACC
@docbhardwaj · X

@emily_fri If no past h/o thromboemboli or low Chadsvasc, not a fan of bridging with heparin. Unless major concern of hypercoaguable state. https://t.co/dDLNXjDF5O

Jul 13, 2023 · 8 likes · 4,553 followers View post →
Hiteshi KC Chauhan
@HiteshiKc · X

RT @djc795: @emily_fri Bridging has been proven harmful in stable patients. Hard to imagine it is less harmful in critically ill patients…

Jul 13, 2023 · 3 shares · 444 followers View post →
Emily Fridenmaker
@emily_fri · X

RT @djc795: @emily_fri Bridging has been proven harmful in stable patients. Hard to imagine it is less harmful in critically ill patients…

Jul 13, 2023 · 3 shares · 36,248 followers View post →
David J. Cohen, MD, MSc
@djc795 · X

@emily_fri Bridging has been proven harmful in stable patients. Hard to imagine it is less harmful in critically ill patients. Hippocratic oath applies. https://t.co/jfLawIzZ1V

Jul 13, 2023 · 43 likes · 3 shares · 19,079 followers View post →
Willy Frick
@willyhfrick · X

@DxRxEdu @UREssien @CKaneshiroMD We need an updated BRIDGE in the DOAC era. https://t.co/mH17IjsGr1

Jun 1, 2023 · 10 likes · 4,060 followers View post →
UPMC Mercy Internal Medicine Residency
@UPMCMercyIM · X

Some studies always stay young! A reminder of this fascinating study shared by our #chiefresident @AaronWalkerMD for the #morningreport #afib #CardioTwitter #MedTwitter Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation | NEJM https://t.co/I6Sk6Rqldw

Feb 13, 2023 · 3,111 followers View post →
Herr Fö
@sebbofoe · X

@rogguronium https://t.co/mDLZtjawZw

Oct 13, 2022 · 2 likes · 1,102 followers View post →
PJ-KEN
@PJKEN001 · X

RT @cardio_dr_ys: ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170…

Oct 12, 2022 · 6 shares · 383 followers View post →
TSK
@TSK010 · X

RT @cardio_dr_ys: ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170…

Oct 12, 2022 · 6 shares · 684 followers View post →
いのぶ
@81nE8x9OiPQsbLm · X

RT @cardio_dr_ys: ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170…

Oct 12, 2022 · 6 shares · 643 followers View post →
後藤礼司 Reiji Goto MD, PhD
@dr_reiji7 · X

RT @cardio_dr_ys: ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170…

Oct 11, 2022 · 6 shares · 11,896 followers View post →
色々自粛中(ガラス細工の様な繊細なハートを持つ貴公子
@ECGEPSCADEVICE · X

RT @cardio_dr_ys: ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170…

Oct 11, 2022 · 6 shares · 9,404 followers View post →
Yoichiro.S@循環器内科医
@cardio_dr_ys · X

ref.1 Perioperative management of patients with drug-eluting stents. JACC Cardiovasc Interv 2010; 3: 131–142. PMID: 20170869 ref.2 Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. NEJM2015; 373: 823–833. PMID: 26095867

Oct 11, 2022 · 18 likes · 6 shares · 3,475 followers View post →
Me
@mattdoc1988 · X

@jdrwilcox @spitinmemouf @IM_Crit_ Yes… we struggle to get IV heparin right on HDU/ICU with 1:1 nursing and plenty of vascular access! Of note the BRIDGE trial - https://t.co/i0Obye74nd

Oct 9, 2022 · 1 like · 1,214 followers View post →
Rebecca Berger
@RebeccaEBerger · X

And used the landmark @NEJM BRIDGE trial to decide not to start LMWH for a patient with AFib admitted for a procedure https://t.co/P0vXTLfUqC (9/X)

Sep 23, 2022 · 1 like · 3,664 followers View post →
おりか
@S7hBv · X

RT @cardio_dr_ys: @S7hBv 有名どころとしてはこちらでしょうか。 Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation https://t.co/W61JV…

Jul 24, 2022 · 1 share · 6,126 followers View post →
Yoichiro.S@循環器内科医
@cardio_dr_ys · X

@S7hBv 有名どころとしてはこちらでしょうか。 Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation https://t.co/W61JVy8c01

Jul 24, 2022 · 4 likes · 1 share · 3,475 followers View post →
Haley Sorensen
@HaleySorensenDo · X

This is from the BRIDGE trial https://t.co/isMng1GMfn

Jul 7, 2022 · 25 followers View post →
Sachin Goel
@SachinGoelMD · X

@GilbertTangMD @djc795 @mirvatalasnag @Argenscore @HarryDauerman @tnazifMD @TsuyoshiKaneko1 @lamelaspablo @ryankaple @M_Pompeu_Sa_MD @JACCJournals Agree, for those who haven’t, here it is: https://t.co/scpV0eDF9Z

May 4, 2022 · 1 like · 6,507 followers View post →
Zain Chagla
@zchagla · X

I’m slightly extrapolating this and considering even higher risks for a pause - but happy to hear opinion https://t.co/ggClAlK4O9

Apr 1, 2022 · 2 likes · 19,583 followers View post →
MCATStudent55555
@MCATStudent555 · X

The BRIDGE trial is a noninferiority trial enrolling 1884 patients and comparing subcutaneous injections of LMWH (lovenox) versus placebo in afib patients on warfarin who need to undergo surgery. https://t.co/OjeriR6vQx

Mar 9, 2022 View post →
Daniel Toro Reina
@danieltoro1991 · X

RT @Ad_SotoMota: Ganó el BRIDGE! https://t.co/g7lMNTFjS0 Nos vemos el jueves! https://t.co/XNJTyyay1H

Jan 12, 2022 · 2 shares · 98 followers View post →
Dexmedetomidina
@hexolum_fakir · X

RT @Ad_SotoMota: Ganó el BRIDGE! https://t.co/g7lMNTFjS0 Nos vemos el jueves! https://t.co/XNJTyyay1H

Jan 11, 2022 · 2 shares · 515 followers View post →
Adrian Soto-Mota
@AdrianSotoMota · X

Ganó el BRIDGE! https://t.co/g7lMNTFjS0 Nos vemos el jueves! https://t.co/XNJTyyay1H

Jan 11, 2022 · 11 likes · 2 shares · 9,202 followers View post →
Adrian Soto-Mota
@AdrianSotoMota · X

Opción 1: ¿Hay que "puentear" (traslapar heparina y anticoagulantes) a los pacientes con fibrilación auricular antes de una cirugía? El estudio BRIDGE: https://t.co/g7lMNTFjS0

Jan 10, 2022 · 7 likes · 9,202 followers View post →
Samiah Abdullah
@samiah25 · X

BRIDGE TRIAL

Dec 22, 2021 · 666 followers View post →
Junaid Ansari
@juneuromd · X

The earlier BRIDGE trial studied warfarin discontinuation and need for LMWH bridging in a perioperative setting which was also a non inferior study to placebo https://t.co/KrmayIgXDY

Jul 23, 2021 · 8,350 followers View post →
Todd C. Lee
@DrToddLee · X

@ABsteward @bmj_latest Confirmation of BRIDGE? https://t.co/RFpeyJOv6q

Jun 9, 2021 · 6 likes · 15,066 followers View post →
SPRC
@PeriopSociety · X

Mark you Calendars! The next Perioperative Care Journal Club meeting - Wed., May 26 at 6:00 pm EDT - Dr. Hannah MacKenzie will discuss Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation (BRIDGE Trial). Very pleased to have Dr. James Douketis joining us.

May 12, 2021 · 3 likes · 67 followers View post →
Mike Glover
@glovedoc · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

May 1, 2021 · 8 shares · 427 followers View post →
Adam Suleman
@adamsuleman03 · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

May 1, 2021 · 8 shares · 540 followers View post →
Abdullah AlRajhi
@3bdullahM · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

May 1, 2021 · 8 shares · 763 followers View post →
Carme Font
@CarmeFont2 · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

May 1, 2021 · 8 shares · 673 followers View post →
Geoff Barnes
@GBarnesMD · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

May 1, 2021 · 8 shares · 5,373 followers View post →
Paul Riley
@PaulRileySparta · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

May 1, 2021 · 8 shares · 282 followers View post →
Mike Thompson, MD, PhD, FASCO
@mtmdphd · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

Apr 30, 2021 · 8 shares · 23,023 followers View post →
Santhosh Ambika
@RenoHemonc · X

RT @Bloodman: Consult article day 5 - stop bridging people!!

Apr 30, 2021 · 8 shares · 4,109 followers View post →
Bloodman
@Bloodman · X

Consult article day 5 - stop bridging people!!

Apr 30, 2021 · 24 likes · 8 shares · 6,433 followers View post →
Matt Siuba
@msiuba · X

@economicexile That was periop right? https://t.co/XfDrcjV94L

Feb 22, 2021 · 8 likes · 16,990 followers View post →
Alexander Chaitoff
@AlexChaitoff · X

In folks w/ afib, do we need to bridge anticoagulation peri-procedurally? Usually not! i.e. the BRIDGE trial and PAUSE study show pretty low rates of bleeding and few strokes just holding then restarting anticoagulation. https://t.co/ttGFE1eNIi https://t.co/VrmnNllNJC

Feb 9, 2021 · 4 likes · 1,654 followers View post →
Adnan Nadir
@TribelessSapien · X

@GilbertTangMD @djc795 @mirvatalasnag @Argenscore @HarryDauerman @tnazifMD @TsuyoshiKaneko1 @lamelaspablo @ryankaple @M_Pompeu_Sa_MD @JACCJournals In a RCT of AF patients no benefit of bridging was found, so definitely no bridging. https://t.co/4SzfwwUg1Q

Dec 24, 2020 · 1 like · 1,356 followers View post →
Shibley
@dr_shibley · X

Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation | NEJM https://t.co/yDI6A4WYPI

Jun 28, 2020 · 27,480 followers View post →
Adam Kittai
@AdamKittai · X

@Bloodman trained me well. Question whether bridging is necessary, especially for patients who have paroxysmal atrial fibrillation. BRIDGE trial showed non-inferiority of no AC vs. bridging AC for peri-operative procedures. #medtwitter https://t.co/vxFvqD4j8b

Mar 7, 2020 · 3 likes · 1,059 followers View post →
Neuroscience Files
@neurofiles1 · X

RT @pablolavados: Este es otro tema y datos contra-intuitivos a tener en cuenta en pacientes con #FA y #anticoagulados; no hacer terapia pu…

Aug 22, 2019 · 3 shares · 931 followers View post →
Ana Agudo
@ana_agudog · X

RT @pablolavados: Este es otro tema y datos contra-intuitivos a tener en cuenta en pacientes con #FA y #anticoagulados; no hacer terapia pu…

Aug 22, 2019 · 3 shares · 5 followers View post →
Felipe Sebastián
@PipeTatanVP · X

RT @pablolavados: Este es otro tema y datos contra-intuitivos a tener en cuenta en pacientes con #FA y #anticoagulados; no hacer terapia pu…

Aug 21, 2019 · 3 shares · 1,163 followers View post →
Pablo M Lavados
@PabloLavados · X

Este es otro tema y datos contra-intuitivos a tener en cuenta en pacientes con #FA y #anticoagulados; no hacer terapia puente con heparinas si se van a operar. @interneurona Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation | NEJM https://t.co/XPFcRpfMiN

Aug 21, 2019 · 11 likes · 3 shares · 1,366 followers View post →
Frederico Dall'Orto
@FredDallOrto · X

Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation | NEJM https://t.co/aTNMVVo6jI

Jul 10, 2019 · 169 followers View post →
澤野豊明(Toyoaki Sawano)|外科医
@Toyoakisawano · X

参考文献 https://t.co/iU182pYx7H

Apr 3, 2019 · 12 likes · 4,230 followers View post →
The Phlegmfighter
@phlegmfighter · X

@bogdienache @VPrasadMDMPH I guess they were that the program directors favored them? On the other hand, what was the evidence that work hours restrictions had net benefits that justified it as standard? I see it like the Douketis et al #NIFT of #bridginganticoagulation https://t.co/dnjHuAAN50

Mar 12, 2019 · 1 like · 7,256 followers View post →
Federico Bottaro
@fedebotta1 · X

No es No. #bridge study (DOI: 10.1056/NEJMoa1501035) nos mostró que en paciente ACO por FA no valvular NO debemos hacer puente con HBPM peri-operatorio: Igual trombo/Mayor sangrado. ¿Y si la razón de ACO fuera Enfermedad Tromboembólica Venosa (ETV)?

Feb 28, 2019 · 466 followers View post →