In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 3 ( 2021-3-25), p. e0248359-
Abstract:
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 Östergötland, 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.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0248359
DOI:
10.1371/journal.pone.0248359.g001
DOI:
10.1371/journal.pone.0248359.t001
DOI:
10.1371/journal.pone.0248359.t002
DOI:
10.1371/journal.pone.0248359.t003
DOI:
10.1371/journal.pone.0248359.t004
DOI:
10.1371/journal.pone.0248359.t005
DOI:
10.1371/journal.pone.0248359.s001
DOI:
10.1371/journal.pone.0248359.s002
DOI:
10.1371/journal.pone.0248359.s003
DOI:
10.1371/journal.pone.0248359.s004
DOI:
10.1371/journal.pone.0248359.r001
DOI:
10.1371/journal.pone.0248359.r002
DOI:
10.1371/journal.pone.0248359.r003
DOI:
10.1371/journal.pone.0248359.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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