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  3. Adherence to periprocedural antithrombotic treatment recommendations and its prognostic impact in patients with high ischemic and hemorrhagic risk;

Adherence to periprocedural antithrombotic treatment recommendations and its prognostic impact in patients with high ischemic and hemorrhagic risk;

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Anguita-Gámez M.
  • Vivas D.
  • Esteve-Pastor M.A.
  • González-Manzanares R.
  • Igualada J.
  • Egocheaga I.
  • Nozal-Mateo B.
  • Abad-Motos A.
  • Figuero E.
  • Bouzó-Molina N.
  • Lozano T.
  • Álvarez-Ortega C.
  • Torres J.
  • Descalzo M.J.
  • Catalá J.C.
  • Martín-Rioboo E.
  • Moliner A.
  • Rodríguez-Contreras R.
  • Carnero-Alcázar M.
  • Marín F.
  • Anguita M.

Grupos

Abstract

Introduction and objectives: To analyze the clinical impact of the inappropriate use of antithrombotic treatment in patients with high ischemic or hemorrhagic risk during the periprocedural/perisurgical period in Spain. Methods: Prospective multicenter observational registry of patients receiving antiplatelet and/or anticoagulant therapy who required an intervention. The incidence of 30-day events was compared based on the peri-intervention management of antithrombotic treatment and the patients’ risk classification (high vs. moderate-to-low risk). The primary endpoint was a composite of death, cardiovascular ischemic events, or bleeding events classified as BARC 2 or higher. Results: A total of 1152 patients were analyzed. Of these, 1.9% had both high ischemic and hemorrhagic risks (A);10.8% had high ischemic risk and low-to-moderate hemorrhagic risk (B); 12% had high hemorrhagic risk and low-to-moderate ischemic risk (C); and 75.3% had both low-to-moderate risks (D). The prevalence of inappropriate treatment was higher in the subgroup with high hemorrhagic risk and low-to-moderate ischemic risk (C) (62.6% vs 40.9% in subgroup A; P < .05; 40.3% in subgroup B; P < .001; and 39.8% in subgroup D; P < .05). The incidence of the composite endpoint was higher in the subgroups with high ischemic and hemorrhagic risks (22.7%) and high ischemic and low-to-moderate hemorrhagic risks (20.9%), compared with 3.6% in subgroup C (P < .05) and 5.7% in subgroup D (P < .001). Among patients with inappropriate treatment, the incidence of the composite endpoint was significantly higher in subgroups with high ischemic and hemorrhagic risks (44.4% vs 7.7%; P = .043) and high ischemic and low-to-moderate hemorrhagic risks (30% vs 14.8%; P = .042). Conclusions: The prevalence of inappropriate periprocedural/perisurgical treatment was higher in patients with high hemorrhagic risk and low-to-moderate ischemic risk. The incidence of events was higher in patients with high ischemic risk, with inadequate antithrombotic management being associated with a higher event rate in these groups. © 2024 Sociedad Española de Cardiología

Datos de la publicación

ISSN/ISSNe:
0300-8932, 1579-2242

REVISTA ESPANOLA DE CARDIOLOGIA  EDICIONES DOYMA S A

Tipo:
Article
Páginas:
416-424
PubMed:
39522718
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,407 SCImago ℠
Cuartil:
Q3 SCImago ℠

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Keywords

  • Aged; Female; Fibrinolytic Agents; Follow-Up Studies; Guideline Adherence; Hemorrhage; Humans; Incidence; Male; Middle Aged; Myocardial Ischemia; Prognosis; Prospective Studies; Registries; Risk Assessment; Risk Factors; Spain; anticoagulant agent; antithrombocytic agent; fibrinolytic agent; anticoagulant therapy; Article; bleeding; controlled study; disease risk assessment; high risk patient; human; incidence; intermediate risk patient; ischemia; low risk patient; major clinical study; medication compliance; observational study; patient compliance; patient registry; perioperative care; prevalence; prognosis; prospective study; Spain; surgical risk; aged; clinical trial; epidemiology; female; follow up; heart muscle ischemia; male; middle aged; multicenter study; procedures; prognosis; protocol compliance; register; risk assessment; risk factor

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