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Coronary artery byp...
Coronary artery bypass grafting-related bleeding complications in patients treated with ticagrelor or clopidogrel : a nationwide study
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- Hansson, Emma C., 1985 (författare)
- Sahlgrens Univ Hosp, Dept Cardiothorac Surg, SE-41345 Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
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- Jideus, Lena (författare)
- Uppsala universitet,Thoraxkirurgi,Dept Cardiothorac Surg, Univ Uppsala Hosp, Uppsala, Sweden,University Hospital, Uppsala, Sweden
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- Aberg, Bengt (författare)
- Blekinge Hosp, Dept Cardiothorac Surg, Karlskrona, Sweden.,Blekinge Hospital, Karlskrona, Sweden
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- Bjursten, Henrik (författare)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital, Lund, Sweden
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- Dreifaldt, Mats (författare)
- Univ Hosp, Dept Cardiothorac Surg, Orebro, Sweden.;Univ Hlth Care Res Ctr, Orebro, Sweden.,Dept Cardiothorac; Univ Hlth Care Res Ctr, Region Örebro County, Örebro, Sweden,University Hospital and University Health Care Research Centre, Örebro, Sweden
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- Holmgren, Anders (författare)
- Univ Umea Hosp, Dept Cardiothorac Surg, S-90185 Umea, Sweden.,University Hospital, Umeå, Sweden.
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- Ivert, Torbjorn (författare)
- Karolinska Institutet
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- Nozohoor, Shahab (författare)
- Skane Univ Hosp, Dept Cardiothorac Surg, Lund, Sweden.,Skåne University Hospital, Sweden
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- Barbu, Mikael (författare)
- Blekinge Hosp, Dept Cardiothorac Surg, Karlskrona, Sweden.,Blekinge Hospital, Karlskrona, Sweden
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- Svedjeholm, Rolf (författare)
- Linköpings universitet,Östergötlands Läns Landsting,Thorax-kärlkliniken i Östergötland,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten
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- Jeppsson, Anders, 1960 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Sahlgrens Univ Hosp, Dept Cardiothorac Surg, SE-41345 Gothenburg, Sweden Sahlgrenska University Hospital, Gothenburg, Sweden (creator_code:org_t)
- 2015-09-01
- 2016
- Engelska.
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 37:2, s. 189-197
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- AIMS:Excessive bleeding impairs outcome after coronary artery bypass grafting (CABG). Current guidelines recommend withdrawal of clopidogrel and ticagrelor 5 days (120 h) before elective surgery. Shorter discontinuation would reduce the risk of thrombotic events and save hospital resources, but may increase the risk of bleeding. We investigated whether a shorter discontinuation time before surgery increased the incidence of CABG-related major bleeding complications and compared ticagrelor- and clopidogrel-treated patients.METHODS AND RESULTS:All acute coronary syndrome patients in Sweden on dual antiplatelet therapy with aspirin and ticagrelor (n = 1266) or clopidogrel (n = 978) who underwent CABG during 2012-13 were included in a retrospective observational study. The incidence of major bleeding complications according to the Bleeding Academic Research Consortium-CABG definition was 38 and 31%, respectively, when ticagrelor/clopidogrel was discontinued <24 h before surgery. Within the ticagrelor group, there was no significant difference between discontinuation 72-120 or >120 h before surgery [odds ratio (OR) 0.93 (95% confidence interval, CI, 0.53-1.64), P = 0.80]. In contrast, clopidogrel-treated patients had a higher incidence when discontinued 72-120 vs. >120 h before surgery (OR 1.71 (95% CI 1.04-2.79), P = 0.033). The overall incidence of major bleeding complications was lower with ticagrelor [12.9 vs. 17.6%, adjusted OR 0.72 (95% CI 0.56-0.92), P = 0.012].CONCLUSION:The incidence of CABG-related major bleeding was high when ticagrelor/clopidogrel was discontinued <24 h before surgery. Discontinuation 3 days before surgery, as opposed to 5 days, did not increase the incidence of major bleeding complications with ticagrelor, but increased the risk with clopidogrel. The overall risk of major CABG-related bleeding complications was lower with ticagrelor than with clopidogrel.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Dual antiplatelet therapy
- Acute coronary syndrome
- Bleeding complications
- Cardiac surgery
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Hansson, Emma C. ...
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Jideus, Lena
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Aberg, Bengt
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Bjursten, Henrik
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Dreifaldt, Mats
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Holmgren, Anders
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visa fler...
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Ivert, Torbjorn
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Nozohoor, Shahab
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Barbu, Mikael
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Svedjeholm, Rolf
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Jeppsson, Anders ...
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
- Artiklar i publikationen
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European Heart J ...
- Av lärosätet
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Uppsala universitet
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Örebro universitet
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Lunds universitet
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Linköpings universitet
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Karolinska Institutet
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Göteborgs universitet