کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3466097 1596551 2014 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Clinical outcome in patients with venous thromboembolism receiving concomitant anticoagulant and antiplatelet therapy
ترجمه فارسی عنوان
نتیجه بالینی در بیماران مبتلا به ترومبوآمبولیون وریدی که از داروهای ضد انعقاد و آنتی ترومبولیک همزمان استفاده می کنند
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی


• Antiplatelets were stopped in 62% of VTE patients—mostly women and DVT patients.
• VTE patients continuing antiplatelets had a higher rate of major adverse outcomes.
• Combined antiplatelet/anticoagulant therapy did not raise bleeding risk in VTE.

IntroductionPatients with arterial disease receiving antiplatelet agents may develop venous thromboembolism (VTE) and need anticoagulant therapy, although concomitant use of these drugs may increase bleeding risk. We analyzed RIETE data and compared clinical outcomes depending on decision to discontinue or maintain antiplatelet therapy at VTE diagnosis.MethodsConsecutive patients with acute VTE were enrolled in RIETE. Only patients receiving antiplatelet therapy at baseline were included in this analysis. Primary outcomes were: rate of subsequent ischemic events, major bleeding or death during anticoagulation course.Results1178 patients who received antiplatelet drugs at VTE diagnosis were included. Antiplatelet therapy was discontinued in 62% of patients. During anticoagulation course, patients also receiving antiplatelet therapy had higher rates of lower limb amputations (2.28 vs. 0.21 events per 100 patients-years; p < 0.01), any ischemic events (5.7 vs. 2.28 events per 100 patients-years; p < 0.05) or death (23.6 vs. 13.9 deaths per 100 patients-years; p < 0.01). No differences in the rate of major bleeding or recurrent VTE were revealed. In matched analysis, patients on antiplatelet therapy were found to have a significantly higher rate of limb amputations (odds ratio: 15.3; 95% CI: 1.02–229) and an increased number of composite outcomes including all-cause deaths, arterial and VTE events (odds ratio: 1.46; CI: 1.03–2.06), with no differences in major bleeding rate.ConclusionConcomitant anticoagulant and antiplatelet therapy in patients with VTE and arterial disease is not associated with increased risk for bleeding, recurrent VTE or death. The worse outcome observed in patients who continued antiplatelet therapy requires further investigations.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Journal of Internal Medicine - Volume 25, Issue 9, November 2014, Pages 821–825
نویسندگان
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