دورية أكاديمية

Ticagrelor in Triple Antithrombotic Therapy: Predictors of Ischemic and Bleeding Complications

التفاصيل البيبلوغرافية
العنوان: Ticagrelor in Triple Antithrombotic Therapy: Predictors of Ischemic and Bleeding Complications
المؤلفون: Fu, Angel, Singh, Kuljit, Abunassar, Joseph, Malhotra, Nikita, Le May, Michel, Labinaz, Marino, Glover, Christopher, Marquis, Jean‐Francois, Froeschl, Michael, Dick, Alexander, Hibbert, Benjamin, Chong, Aun‐Yeong, So, Derek Y. F.
المساهمون: Canadian Institutes of Health Research
المصدر: Clinical Cardiology ; volume 39, issue 1, page 19-23 ; ISSN 0160-9289 1932-8737
بيانات النشر: Wiley
سنة النشر: 2016
المجموعة: Wiley Online Library (Open Access Articles via Crossref)
الوصف: Background Patients on dual antiplatelet therapy following percutaneous coronary intervention often have indications for concurrent oral anticoagulation or triple antithrombotic therapy ( TT ). Although TT may decrease ischemic complications, it may confer increased bleeding risk. Hypothesis We hypothesize that the use of ticagrelor in TT is associated with higher risk of complications; accordingly, we sought to determine predictors of complications in patients on TT. Methods Patients discharged on TT after percutaneous coronary intervention were followed prospectively for 12 months. The primary endpoint was a composite of ischemic (death, myocardial infarction, stroke) and major bleeding complications or net adverse clinical event ( NACE ). A major secondary endpoint was BARC (Bleeding Academic Research Consortium) types 2, 3, or 5 bleeding. Outcomes were compared between ticagrelor‐ and clopidogrel‐treated patients. Multivariable analyses were performed to elucidate predictors of complications. Results Twenty‐seven of 152 patients discharged on TT were on ticagrelor. NACE occurred in 52% of patients and BARC 2, 3, or 5 bleeding occurred in 18%. There was no difference in the primary or secondary outcome between ticagrelor vs clopidogrel subgroup. On logistic regressions, use of TT in patients with acute coronary syndrome ( P = 0.002) and bridging in with ticagrelor ( P = 0.02) were associated with increased NACE . Low estimated glomerular filtration rate was an independent predictor of bleeding ( P = 0.03). Conclusions The risk of bleeding and ischemic complications among patients on TT is similar between those on ticagrelor and clopidogrel. However, caution with use of bridging anticoagulation should be taken when using ticagrelor.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1002/clc.22486
الإتاحة: https://doi.org/10.1002/clc.22486Test
حقوق: http://onlinelibrary.wiley.com/termsAndConditions#vorTest
رقم الانضمام: edsbas.7C9128CC
قاعدة البيانات: BASE