Long term risk and costs of bleeding in men and women treated with triple antithrombotic therapy: An observational study

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Holm, Anna,1973-Linköpings universitet,Medicinska fakulteten,Avdelningen för diagnostik och specialistmedicin,Region Östergötland, Kardiologiska kliniken US (author)

Long term risk and costs of bleeding in men and women treated with triple antithrombotic therapy : An observational study

Article/chapterEnglish2021

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2021-03-25
Public Library of Science,2021
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LIBRIS-ID:oai:DiVA.org:liu-175450
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-175450URI
https://doi.org/10.1371/journal.pone.0248359DOI

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Language:English
Summary in:English

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Funding Agencies|County Council of Ostergotland
Objectives Bleeding is the most common non-ischemic complication in patients with coronary revascularisation procedures, associated with prolonged hospitalisation and increased mortality. Many factors predispose for bleeds in these patients, among those sex. Anyhow, few studies have characterised the population receiving triple antithrombotic therapy (TAT) as well as long term bleeds from a sex perspective. We investigated the one year rate of bleeds in patients receiving TAT, potential sex disparities and premature discontinuation of TAT. We also assessed health care costs in bleeders vs non-bleeders. Setting Three hospitals in the County of ostergotland, Sweden during 2009-2015. Participants All patients discharged with TAT registered in the SWEDEHEART registry. Primary and secondary outcome measures All bleeds receiving medical attention during one-year follow-up were collected by retrieving relevant information about each patient from medical records. Resource use associated with bleeds was assigned unit cost to estimate the health care costs associated with bleeding episodes. Results Among 272 patients, 156 bleeds occurred post-discharge, of which 28.8% were gastrointestinal. In total 54.4% had at least one bleed during or after the index event and 40.1% bled post discharge of whom 28.7% experienced a TIMI major or minor bleeding. Women discontinued TAT prematurely more often than men (52.9 vs 36.1%, p = 0.01) and bled more (48.6 vs. 37.1%, p = 0.09). One-year mean health care costs were EUR 575 and EUR 5787 in non-bleeding and bleeding patients, respectively. Conclusion The high bleeding incidence in patients with TAT, especially in women, is a cause of concern. There is a need for an adequately sized randomised, controlled trial to determine a safe but still effective treatment for these patients.

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Henriksson, MartinLinköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten(Swepub:liu)marhe38 (author)
Alfredsson, Joakim,1962-Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)joaal38 (author)
Janzon, Magnus,1961-Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)magja75 (author)
Johansson, ThereseLinköpings universitet,Institutionen för hälsa, medicin och vård,Medicinska fakulteten(Swepub:liu)n/a (author)
Swahn, EvaLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)evasw45 (author)
Vial, DominiqueLinköpings universitet,Institutionen för hälsa, medicin och vård,Medicinska fakulteten(Swepub:liu)n/a (author)
Sederholm Lawesson, SofiaLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)sofla80 (author)
Linköpings universitetMedicinska fakulteten (creator_code:org_t)

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