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Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation

BACKGROUND: Dual antiplatelet treatment (DAPLT) for at least 12 months is recommended after drug eluting stent (DES) implantation, but concerns regarding the extended use of this treatment persist due to increased risk of bleeding. In this study are assessed the incidence, correlates, and clinical s...

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Autores principales: Voudris, Vassilis, Karyofyllis, Panagiotis, Doulaptsis, Constantinos, Moukas, Ioannis, Thomopoulou, Sofia, Cokkinos, Denis V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497144/
https://www.ncbi.nlm.nih.gov/pubmed/28785613
http://dx.doi.org/10.1016/j.ijcha.2014.10.007
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author Voudris, Vassilis
Karyofyllis, Panagiotis
Doulaptsis, Constantinos
Moukas, Ioannis
Thomopoulou, Sofia
Cokkinos, Denis V.
author_facet Voudris, Vassilis
Karyofyllis, Panagiotis
Doulaptsis, Constantinos
Moukas, Ioannis
Thomopoulou, Sofia
Cokkinos, Denis V.
author_sort Voudris, Vassilis
collection PubMed
description BACKGROUND: Dual antiplatelet treatment (DAPLT) for at least 12 months is recommended after drug eluting stent (DES) implantation, but concerns regarding the extended use of this treatment persist due to increased risk of bleeding. In this study are assessed the incidence, correlates, and clinical significance of bleeding complications in diabetic patients after long-term DAPLT post DES implantation. METHODS: We studied 610 consecutive diabetic patients after DES implantation. The primary end point was the occurrence of any bleeding according to the BARC and TIMI definitions. RESULTS: The incidence of overall bleeding was higher in patients on DAPLT (21.1% vs. 4.4%, p < 0.001); minor/minimal according to the TIMI definition, and type 1 or 2 according to the BARC definition, were more frequently observed in patients on DAPLT (20.3% vs. 3.0%, p < 0.001, 15.6% vs. 2.0%, p < 0.001 and 4.4% vs. 0.5%, p = 0.034, respectively), whereas there was no effect on type 3 (3.5% vs. 2.0%, p = ns). DAPLT was an independent predictor for overall (HR 5.35, 95% CI: 2.69–10.67, p < 0.001), minor (HR 7.45, 95% CI: 3.25–17.12, p < 0.001, for TIMI classification) and type 1 or 2 bleeding (HR 8.17, 95% CI 3.29–20.25, p < 0.001); furthermore smoking was also predictor for overall bleeding (HR 1.65, 95% CI: 1.05–2.61, p = 0.030). Cardiovascular adverse events were not more frequent in patients with bleeding as compared with those without bleeding. CONCLUSIONS: Long-term DAPLT in diabetic patients after DES implantation is associated with higher risk of overall and minor but not major bleeding; smoking may have a significant role in the occurrence of bleeding complications.
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spelling pubmed-54971442017-08-07 Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation Voudris, Vassilis Karyofyllis, Panagiotis Doulaptsis, Constantinos Moukas, Ioannis Thomopoulou, Sofia Cokkinos, Denis V. Int J Cardiol Heart Vasc Article BACKGROUND: Dual antiplatelet treatment (DAPLT) for at least 12 months is recommended after drug eluting stent (DES) implantation, but concerns regarding the extended use of this treatment persist due to increased risk of bleeding. In this study are assessed the incidence, correlates, and clinical significance of bleeding complications in diabetic patients after long-term DAPLT post DES implantation. METHODS: We studied 610 consecutive diabetic patients after DES implantation. The primary end point was the occurrence of any bleeding according to the BARC and TIMI definitions. RESULTS: The incidence of overall bleeding was higher in patients on DAPLT (21.1% vs. 4.4%, p < 0.001); minor/minimal according to the TIMI definition, and type 1 or 2 according to the BARC definition, were more frequently observed in patients on DAPLT (20.3% vs. 3.0%, p < 0.001, 15.6% vs. 2.0%, p < 0.001 and 4.4% vs. 0.5%, p = 0.034, respectively), whereas there was no effect on type 3 (3.5% vs. 2.0%, p = ns). DAPLT was an independent predictor for overall (HR 5.35, 95% CI: 2.69–10.67, p < 0.001), minor (HR 7.45, 95% CI: 3.25–17.12, p < 0.001, for TIMI classification) and type 1 or 2 bleeding (HR 8.17, 95% CI 3.29–20.25, p < 0.001); furthermore smoking was also predictor for overall bleeding (HR 1.65, 95% CI: 1.05–2.61, p = 0.030). Cardiovascular adverse events were not more frequent in patients with bleeding as compared with those without bleeding. CONCLUSIONS: Long-term DAPLT in diabetic patients after DES implantation is associated with higher risk of overall and minor but not major bleeding; smoking may have a significant role in the occurrence of bleeding complications. Elsevier 2014-10-16 /pmc/articles/PMC5497144/ /pubmed/28785613 http://dx.doi.org/10.1016/j.ijcha.2014.10.007 Text en © 2014 The Authors. Published by Elsevier Ireland Ltd. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Article
Voudris, Vassilis
Karyofyllis, Panagiotis
Doulaptsis, Constantinos
Moukas, Ioannis
Thomopoulou, Sofia
Cokkinos, Denis V.
Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
title Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
title_full Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
title_fullStr Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
title_full_unstemmed Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
title_short Long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
title_sort long-term dual antiplatelet treatment and bleeding complications in diabetic patients treated with drug eluting stent implantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497144/
https://www.ncbi.nlm.nih.gov/pubmed/28785613
http://dx.doi.org/10.1016/j.ijcha.2014.10.007
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