Reginald E. Smith, PharmD

Reg Smith is a Clinical Pharmacy Specialist in Cardiology at the Royal Jubilee Hospital (RJH) in Victoria, BC, and a Clinical Researcher at the Victoria Heart Institute.

He operates the Venous and Arterial Thromboembolism Clinic for the Vancouver Island Health Authority. He is also a Clinical Instructor in the Island Medical Program, University of Victoria, and the Faculty of Pharmaceutical Science at the University of British Columbia.

Dr. Smith’s area of research interest is in anticoagulation and antithrombotic therapies. He has been either a principle or co-investigator in more than 50 clinical trials, including many in the treatment and prevention of venous or arterial thromboembolism.

A large portion of Dr. Smith’s clinical practice is in the perioperative/periprocedural management of anticoagulation.

Dr. Smith was the recipient of a Pfizer Cardiovascular Research Grant Award for 2007 on behalf of the Canadian Cardiovascular Pharmacists Network.

Anticoagulation Bridging for Surgical Procedures: Practical Solutions

Thursday, March 20, 2008
8:30 AM

Download Dr. Smith’s complete slide set [23.5 MB PPT].
Download Dr. Smith’s featured preconference slides [1.20 MB PDF].

High volumes of patients who are either chronically anticoagulated or using dual antiplatelet therapy (ASA + Clopidogrel) are being admitted or discharged from health care centers for invasive procedures. These patients may or may not receive bridging anticoagulation therapy which usually consists of heparins or low molecular weight heparins.

Patients who don’t receive bridging may be at risk of venous or arterial thromboembolism while their anticoagulation is stopped, and patients who do receive bridging may be at increased risk of hemorrhagic complications following their procedure. Patients with recent venous thromboembolism may require mechanical devices such as inferior vena caval filters or intermittent pneumatic compression.

During this presentation we will do a case-based discussion on risk stratification (for thromboembolism/hemorrhage) of patients with prosthetic heart valves, atrial fibrillation and venous thromboembolism who require temporary interruption of anticoagulation for invasive procedures.

Furthermore, we will discuss common bridging strategies and issues and review findings from completed and ongoing clinical trials.