Major bleeding risk in anticoagulated patients receiving concomitant antiplatelet therapy: A prospective study.

Détails

ID Serval
serval:BIB_7D0B2FEBD531
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Major bleeding risk in anticoagulated patients receiving concomitant antiplatelet therapy: A prospective study.
Périodique
Thrombosis Research
Auteur(s)
Donzé J., Rodondi N., Waeber G., Cornuz J., Aujesky D.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Statut éditorial
Publié
Date de publication
2013
Peer-reviewed
Oui
Volume
131
Numéro
6
Pages
502-507
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
INTRODUCTION: Current literature suggesting a higher bleeding risk during combination therapy compared to oral anticoagulation alone is primarily based on retrospective studies or specific populations. We aimed to prospectively evaluate whether unselected medical patients on oral anticoagulation have an increased risk of bleeding when on concomitant antiplatelet therapy.
MATERIAL AND METHODS: We prospectively studied consecutive adult medical patients who were discharged on oral anticoagulants between 01/2008 and 03/2009 from a Swiss university hospital. The primary outcome was the time to a first major bleed on oral anticoagulation within 12months, adjusted for age, international normalized ratio target, number of medications, and history of myocardial infarction and major bleeding.
RESULTS: Among the 515 included anticoagulated patients, the incidence rate of a first major bleed was 8.2 per 100 patient-years. Overall, 161 patients (31.3%) were on both anticoagulant and antiplatelet therapy, and these patients had a similar incidence rate of major bleeding compared to patients on oral anticoagulation alone (7.6 vs. 8.4 per 100 patient-years, P=0.81). In a multivariate analysis, the association of concomitant antiplatelet therapy with the risk of major bleeding was not statistically significant (hazard ratio 0.89, 95% confidence interval, 0.37-2.10).
CONCLUSIONS: The risk of bleeding in patients receiving oral anticoagulants combined with antiplatelet therapy was similar to patients receiving oral anticoagulants alone, suggesting that the incremental bleeding risk of combination therapy might not be clinically significant.
Pubmed
Web of science
Création de la notice
26/07/2013 16:30
Dernière modification de la notice
20/08/2019 14:38
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