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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Incidence of Bleeding and Compliance on Prolonged Dual Antiplatelet Therapy (Aspirin + Thienopyridine) Following Drug-Eluting Stent Implantation
American Journal of Cardiology, Volume 102, No. 11, Year 2008
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Description
Prolonged periods of dual antiplatelet therapy (DAT), i.e., aspirin plus a thienopyridine, are currently recommended to prevent late drug-eluting stent (DES) thrombosis. The aim of our study was to determine the risk and predictors of bleeding and compliance associated with such prolongation of DAT. In this observational study we examined 2,355 consecutive patients undergoing successful DES implantation at 4 hospitals in Italy from June 2002 to December 2004. Bleeding events occurring on DAT and warfarin or in the first 30 days after stent implantation were excluded. Median duration of DAT was 209 days (interquartile range 178 to 444) and only 158 patients (6.7%) prematurely discontinued DAT. The overall bleeding rate was 1.9% (45), with major bleeding in 19 (0.8%) and minor bleeding in 26 (1.1%). Independent predictors of bleeding were DAT (hazard ratio 19.8, 95% confidence interval [CI] 3.69 to 106.34, p <0.001) and age >65 years (hazard ratio 2.15, 95% CI 1.16 to 4.00, p = 0.02). In patients on DAT, the incidence rate (30 days to 18 months) of any bleeding event was 2.57 per 100 person-years (95% CI 1.85 to 3.48) and major bleeding was 1.10 per 100 person-years (95% CI 0.65 to 1.74). In conclusion, DAT after DES implantation is well tolerated and associated with a very low risk of major bleeding. © 2008 Elsevier Inc. All rights reserved.
Authors & Co-Authors
Latib, Azeem M.
South Africa, Cape Town
University of Cape Town
Italy, Milan
Irccs Ospedale San Raffaele
Morici, Nuccia
Italy, Milan
Sant'ambrogio Clinical Institute
Cosgrave, John V.
Italy, Milan
Emo Centro Cuore Columbus
Airoldi, Flavio
Italy, Milan
Irccs Ospedale San Raffaele
Italy, Milan
Emo Centro Cuore Columbus
Godino, Cosmo
Italy, Milan
Irccs Ospedale San Raffaele
Brambilla, N.
Italy, Milan
Sant'ambrogio Clinical Institute
Chieffo, Alaide
Italy, Milan
Irccs Ospedale San Raffaele
Bonizzoni, Erminio
Italy, Milan
Università Degli Studi Di Milano
Carlino, Mauro
Italy, Milan
Irccs Ospedale San Raffaele
Bedogni, Francesco
Italy, Milan
Irccs Ospedale San Raffaele
Italy, Milan
Sant'ambrogio Clinical Institute
Montorfano, Matteo
Italy, Milan
Irccs Ospedale San Raffaele
Sangiorgi, Giuseppe
Italy, Milan
Irccs Ospedale San Raffaele
Italy, Milan
Emo Centro Cuore Columbus
Briguori, Carlo
Italy, Naples
Clinica Mediterranea
Colombo, Antonio
Italy, Milan
Irccs Ospedale San Raffaele
Italy, Milan
Emo Centro Cuore Columbus
Statistics
Citations: 23
Authors: 14
Affiliations: 6
Identifiers
Doi:
10.1016/j.amjcard.2008.07.038
ISSN:
00029149
Research Areas
Environmental
Study Design
Cohort Study