Document Detail

Risk of Bleeding on Triple Antithrombotic Therapy After Percutaneous Coronary Intervention/Stenting: A Systematic Review and Meta-analysis.
MedLine Citation:
PMID:  23036279     Owner:  NLM     Status:  Publisher    
BACKGROUND: There are no reported randomized controlled trials of triple antithrombotic therapy (TT; aspirin plus a thienopyridine plus vitamin K antagonist) vs dual antiplatelet therapy (DAPT; aspirin plus a thienopyridine) among patients undergoing percutaneous coronary intervention with stenting (PCI-S). A systematic review and meta-analysis was undertaken to assess the risk of bleeding among patients receiving TT after PCI-S. METHODS: Electronic databases were searched for studies reporting bleeding among patients receiving TT after PCI-S. Of the 4108 articles screened, 18 met study inclusion criteria and underwent detailed data extraction: of these, 6 reported in-hospital outcomes, 14 reported 30-day outcomes, and 9 reported 6-month outcomes. At each time point, pooled estimates of bleeding with TT were ascertained and where possible summary odds ratios (ORs) for comparative risks vs DAPT were calculated. RESULTS: The pooled estimate of major bleeding rate with TT post PCI-S was 2.38% by 30 days postprocedure (95% confidence interval [CI], 0.98-3.77%) and 4.55% by 6 months postdischarge (95% CI, 0.56-8.53%). At 30 days and 6 months the rates of major bleeding with TT were significantly higher than those observed with DAPT: OR, 2.38 at 30 days (95% CI, 1.05-5.38) and OR, 2.87 at 6 months (95% CI, 1.47-5.62). CONCLUSIONS: This systematic review and meta-analysis of reports of triple therapy with a vitamin K antagonist, aspirin, and clopidogrel after PCI-S provides precise and valid bleeding risk data. Based on existing observational studies the rates of major and any bleeding associated with TT are clinically important and significantly greater than those reported with DAPT.
Jason G Andrade; Marc W Deyell; Clarence Khoo; May Lee; Karin Humphries; John A Cairns
Related Documents :
1083139 - Aortocoronary bypass surgery: correlation of angiographic symptomatic and functional im...
23644079 - Early administration of azathioprine vs conventional management of crohn's disease: a r...
24851729 - Effect of surgical incision management on wound infections in a poststernotomy patient ...
23120699 - Objective acoustic analysis of voice improvement after phonosurgery.
24525389 - A non-experimental study of oral anticoagulation therapy initiation before and after na...
23121439 - Bedside monitoring to adjust antiplatelet therapy for coronary stenting.
15332099 - Intravitreal preservative-free triamcinolone acetonide for the treatment of macular oed...
23869439 - A comparison of right posterior sectorectomy with formal right hepatectomy: a dual-inst...
17208539 - Are the long-term results of the transanal pull-through equal to those of the transabdo...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-2
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  -     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Medicine, Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Silver nanoparticle-alginate composite beads for point-of-use drinking water disinfection.
Next Document:  Personalized Cardiovascular Medicine: Status in 2012.