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Influence of oral antiplatelet therapy on hemorrhagic complications of pacemaker implantation.
MedLine Citation:
PMID:  23386254     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: We retrospectively assessed the incidence of hemorrhagic complications associated with pacemaker implantation in patients receiving one or more antiplatelet agents. DESIGN AND SETTING: Retrospective multicenter case-control study. Data were collected from three cardiac units in Germany from 2006 to 2010. METHODS: A total of 495 pacemaker patients were enrolled. 99 patients received dual antiplatelet therapy (aspirin and clopidogrel), 198 were given only aspirin and 198 had no antiplatelet therapy (control). Patients were matched for age and sex. Implant-related bleeding complications were defined as major bleeding, if surgical pocket exploration or blood transfusion were needed. Minor bleeding complications were defined as one or more of the following conditions: fall of hemoglobin content >1.5 g/dl not requiring blood transfusion; pocket hematoma; pocket effusion not requiring surgical revision. MEASUREMENTS AND RESULTS: Hemorrhagic complications were seen in 4/198 control patients and 6/198 aspirin-only patients [2 vs. 3 %, p = 0.5, OR = 1.52 (0.42-5.46)]. Patients undergoing dual antiplatelet therapy had significantly more bleeding complications than patients in the aspirin-only group [11/99: 11.1 vs. 3 %, p = 0.005, OR = 3.95 (1.43-11.16)]. Major complications occurred in 1/198 control patients and 2/198 aspirin-only patients [0.5 vs. 1 %, p = 0.6, OR = 2.01 (0.18-22.35)]. In contrast, 7/99 patients undergoing dual antiplatelet therapy exhibited major complications [7.1 vs. 1 %, p = 0.004, OR = 7.46 (1.52-36.50)]. CONCLUSIONS: Although in patients undergoing pacemaker implantation dual antiplatelet therapy with aspirin and clopidogrel caused a significant increase of bleeding complications, the use of aspirin alone was not associated with a significant increase in bleeding complications.
Authors:
Samir M Said; Hans D Esperer; Judit Hahn; Andreas Bollmann; Sergio Richter; Thomas Rauwolf; Roland Prondzinsky; Alexander Schmeisser; Ruediger C Braun-Dullaeus
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-6
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  -     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Centre of Internal Medicine, University Hospital Magdeburg, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany, samir.said@med.ovgu.de.
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