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

Donzé, Jacques; Rodondi, Nicolas; Waeber, Gérard; Cornuz, Jacques; Aujesky, Drahomir (2013). Major bleeding risk in anticoagulated patients receiving concomitant antiplatelet therapy: a prospective study. Thrombosis research, 131(6), pp. 502-507. Elsevier 10.1016/j.thromres.2013.04.033

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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 12 months, 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas and Aujesky, Drahomir

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0049-3848

Publisher:

Elsevier

Language:

English

Submitter:

Patricia Rajaonina

Date Deposited:

25 Feb 2014 10:23

Last Modified:

09 Nov 2015 10:56

Publisher DOI:

10.1016/j.thromres.2013.04.033

PubMed ID:

23726965

BORIS DOI:

10.7892/boris.41772

URI:

https://boris.unibe.ch/id/eprint/41772

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