{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:36:47Z","timestamp":1791578207629,"version":"4.3.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T00:00:00Z","timestamp":1663718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to analyze the characteristics of patients with pericardial effusion requiring pericardiocentesis and to evaluate the safety of pericardiocentesis without discontinuation of anticoagulant or antiplatelet drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective study of patients undergoing pericardiocentesis in our hospital between 2012 and 2022. Patients were categorized into the Antithrombotic Group if they had used any antiplatelet or anticoagulant drugs on the day of pericardiocentesis; otherwise they were categorized into the Non-antithrombotic Group. All procedures were performed by experienced cardiologists with echocardiographic guidance. Bleeding events were defined using the National Institutes of Health scale of adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 501 consecutive patients were identified and 70 cases were under antithrombotic drugs (Antithrombotic Group). Patients in Antithrombotic Group were older, had more comorbidities, presented with lower platelet counts and prolonged activated partial thromboplastin time (all <jats:italic>p<\/jats:italic> &amp;lt; 0.05). Malignancy was the most common etiology for pericardial effusion in both groups (28.6% in Antithrombotic Group and 54.7% in Non-antithrombotic Group) and tuberculosis was the second etiology in the Non-antithrombotic Group (21.9%), while procedure-related effusion (17.1%) accounted for the second cause in the Antithrombotic Group. Two patients in the Antithrombotic Group had mild oozing at the puncture site that resolved without interventions (2.9 vs. 0%, <jats:italic>p<\/jats:italic> = 0.019), and no bleeding events higher than Grade 1 occurred in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although antiplatelet or anticoagulant drugs may put patients undergoing pericardiocentesis at theoretically higher risk of bleeding, our study demonstrated that they are not associated with increased major bleeding complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.1013979","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T04:57:50Z","timestamp":1663736270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The safety of pericardiocentesis in patients under antithrombotic therapy: A single-center experience"],"prefix":"10.3389","volume":"9","author":[{"given":"Yuansong","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengxiang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqiao","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan Richard","family":"Sasmita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenxian","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suxin","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.tcm.2018.10.016","article-title":"A contemporary look at pericardiocentesis","volume":"29","author":"Sinnaeve","year":"2019","journal-title":"Trends Cardiovasc Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1007\/s11886-020-01324-y","article-title":"Overview of optimal techniques for pericardiocentesis in contemporary practice","volume":"22","author":"Luis","year":"2020","journal-title":"Curr Cardiol Rep."},{"key":"B3","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.pcad.2016.12.009","article-title":"Pericardial effusions: causes, diagnosis, and management","volume":"59","author":"Vakamudi","year":"2017","journal-title":"Prog Cardiovasc Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1111\/j.1440-1843.2012.02230.x","article-title":"Is chest tube insertion with ultrasound guidance safe in patients using clopidogrel?","volume":"17","author":"Abouzgheib","year":"2012","journal-title":"Respirology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2921","DOI":"10.1093\/eurheartj\/ehv318","article-title":"2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task force for the diagnosis and management of pericardial diseases of the European Society of Cardiology (ESC) endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS)","volume":"36","author":"Adler","year":"2015","journal-title":"Eur Heart J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.ehj.2004.02.002","article-title":"Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology","volume":"25","author":"Maisch","year":"2004","journal-title":"Eur Heart J."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1001\/jama.293.17.2126","article-title":"Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents","volume":"293","author":"Iakovou","year":"2005","journal-title":"JAMA."},{"key":"B8","doi-asserted-by":"publisher","first-page":"38","DOI":"10.4244\/EIJV10I1A8","article-title":"Perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and non-cardiac surgery: a consensus document from Italian cardiological, surgical and anaesthesiological societies","volume":"10","author":"Rossini","year":"2014","journal-title":"Eurointervention."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1016\/j.jclinepi.2015.04.014","article-title":"A simple formula for the calculation of sample size in pilot studies","volume":"68","author":"Viechtbauer","year":"2015","journal-title":"J Clin Epidemiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.echo.2019.11.006","article-title":"Bleeding complications of ultrasound-guided pericardiocentesis in the presence of coagulopathy or thrombocytopenia","volume":"33","author":"Ryu","year":"2020","journal-title":"J Am Soc Echocardiogr."},{"key":"B11","unstructured":""},{"key":"B12","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1186\/s12931-020-01549-z","article-title":"Thoracentesis under clopidogrel is not associated with excessive bleeding events: a cohort study","volume":"21","author":"Perl","year":"2020","journal-title":"Respir Res."},{"key":"B13","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1513\/AnnalsATS.201303-050OC","article-title":"Hemorrhagic complications of thoracentesis and small-bore chest tube placement in patients taking clopidogrel","volume":"11","author":"Mahmood","year":"2014","journal-title":"Ann Am Thorac Soc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/LBR.0b013e3182720428","article-title":"Effect of routine clopidogrel use on bleeding complications after ultrasound-guided thoracentesis","volume":"19","author":"Zalt","year":"2012","journal-title":"J Bronchology Interv Pulmonol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.1016\/j.chest.2020.10.092","article-title":"Antiplatelet drugs and risk of bleeding after bedside pleural procedures: a national multicenter cohort study","volume":"159","author":"Dangers","year":"2021","journal-title":"Chest."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1016\/j.mayocp.2019.01.046","article-title":"The safety of ultrasound-guided thoracentesis in patients on novel oral anticoagulants and clopidogrel: a single-center experience","volume":"94","author":"Patel","year":"2019","journal-title":"Mayo Clin Proc."},{"key":"B17","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.jceh.2015.08.004","article-title":"Safety of ascitic paracentesis in patients with Budd-Chiari syndrome on oral anticoagulation and elevated international normalized ratio","volume":"5","author":"Devarbhavi","year":"2015","journal-title":"J Clin Exp Hepatol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.jaccao.2021.05.005","article-title":"How to perform pericardiocentesis in cancer patients with thrombocytopenia: a single-center experience","volume":"3","author":"Jacob","year":"2021","journal-title":"JACC CardioOncol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"140","DOI":"10.3109\/09537104.2012.749981","article-title":"Pericardiocentesis in patients with thrombocytopenia and high international normalized ratio: case report and review of the literature","volume":"25","author":"Kepez","year":"2014","journal-title":"Platelets."},{"key":"B20","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1378\/chest.123.3.956","article-title":"Pericardiocentesis and pancreatic aspiration needle biopsy in coagulopathic and thrombocytopenic cirrhotic patient","volume":"123","author":"Mindikoglu","year":"2003","journal-title":"Chest."},{"key":"B21","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1016\/j.jacc.2016.05.068","article-title":"Echocardiography and fluoroscopy-guided pericardiocentesis for cancer patients with cardiac tamponade and thrombocytopenia","volume":"68","author":"Iliescu","year":"2016","journal-title":"J Am Coll Cardiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"007598","DOI":"10.1161\/JAHA.117.007598","article-title":"Etiology and long-term outcome of patients undergoing pericardiocentesis","volume":"6","author":"Strobbe","year":"2017","journal-title":"J Am Heart Assoc."},{"key":"B23","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1159\/000368796","article-title":"Pericardiocentesis adverse event risk factors: a nationwide population-based cohort study","volume":"130","author":"Ho","year":"2015","journal-title":"Cardiology."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1093\/icvts\/ivu267","article-title":"Palliative treatment for symptomatic malignant pericardial effusiondagger","volume":"19","author":"Jama","year":"2014","journal-title":"Interact Cardiovasc Thorac Surg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"3022","DOI":"10.1093\/eurheartj\/ehz322","article-title":"Continuous anticoagulation with catheter ablation: answers and questions","volume":"40","author":"Pokorney","year":"2019","journal-title":"Eur Heart J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"137","DOI":"10.11622\/smedj.2019065","article-title":"Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centre","volume":"61","author":"Cheong","year":"2020","journal-title":"Singapore Med J."},{"key":"B27","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11886-017-0867-5","article-title":"Pericardial effusion and cardiac tamponade in the new millennium","volume":"19","author":"Hoit","year":"2017","journal-title":"Curr Cardiol Rep."},{"key":"B28","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1007\/s00059-011-3428-5","article-title":"Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients","volume":"37","author":"Ma","year":"2012","journal-title":"Herz."},{"key":"B29","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1186\/s12879-020-05249-3","article-title":"Spatial-temporal analysis of tuberculosis in Chongqing, China 2011-2018","volume":"20","author":"Yu","year":"2020","journal-title":"BMC Infect Dis."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1016\/S0140-6736(19)30308-3","article-title":"Tuberculosis","volume":"393","author":"Furin","year":"2019","journal-title":"Lancet."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1093\/eurheartj\/ehs372","article-title":"Management of pericardial effusion","volume":"34","author":"Imazio","year":"2013","journal-title":"Eur Heart J."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.1013979\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T04:57:53Z","timestamp":1663736273000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.1013979\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,21]]},"references-count":31,"alternative-id":["10.3389\/fcvm.2022.1013979"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.1013979","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,21]]},"article-number":"1013979"}}