The impact of bleeding in patients with acute coronary syndromes: How to optimize the benefits of treatment and minimize the risk

Canadian Journal of Cardiology

Volumn 23, Issue 8, 2007, Pages 663-671

  Fitchett, David ^a  

^a ST MICHAEL'S HOSPITAL   (Canada)

Author keywords

Acute coronary syndromes; Bleeding; Transfusion

Indexed keywords

ABCIXIMAB; ACETYLSALICYLIC ACID; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; CLOPIDOGREL; CORTICOSTEROID; DALTEPARIN; DIURETIC AGENT; ENOXAPARIN; EPTIFIBATIDE; FIBRINOGEN RECEPTOR ANTAGONIST; FIBRINOLYTIC AGENT; FONDAPARINUX; HEPARIN; HIRULOG; INOTROPIC AGENT; LOW MOLECULAR WEIGHT HEPARIN; METOPROLOL; NONSTEROID ANTIINFLAMMATORY AGENT; PLACEBO; PROTON PUMP INHIBITOR; SIMVASTATIN; STREPTOKINASE; TIROFIBAN; TISSUE PLASMINOGEN ACTIVATOR; WARFARIN;

ACUTE CORONARY SYNDROME; BLEEDING; BLOOD TRANSFUSION; BRAIN HEMORRHAGE; CAUSE OF DEATH; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; DISEASE SEVERITY; DRUG DOSAGE FORM COMPARISON; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG FATALITY; DRUG MEGADOSE; DRUG SAFETY; EARLY INTERVENTION; EROSIVE GASTRITIS; GASTROINTESTINAL HEMORRHAGE; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HEART MUSCLE REVASCULARIZATION; HUMAN; HYPOTENSION; INCIDENCE; LOW DRUG DOSE; MONOTHERAPY; MORTALITY; OPTIMAL DRUG DOSE; PROGNOSIS; RECOMMENDED DRUG DOSE; REVIEW; RHEUMATOID ARTHRITIS; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; RISK FACTOR; RISK REDUCTION; TREATMENT DURATION; UNSTABLE ANGINA PECTORIS; UPPER GASTROINTESTINAL BLEEDING; VASCULAR ACCESS;

EID: 34547493729     PISSN: 0828282X     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0828-282X(07)70229-5     Document Type: Review

References (67)

1. Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators; Yusuf S, Mehra SR, Chrolavicius S, et al. Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med 2006;354:1464-76.
2. Stone GW, McLaurin BT, Cox DA, et al; ACUITY Investigators. Bivalirudin for patients with acute coronary syndromes. N Engl J Med 2006;355:2203-16.
3. Yang X, Alexander KP, Chen AY, et al; CRUSADE Investigators. The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: Results from, the CRUSADE National Quality Improvement Initiative. J Am Coll Cardiol 2005;46:1490-5.
4. Eikelboom J, Hirsh J. Bleeding and management of bleeding. Eur Heart J 2006;8(Suppl G):G38-45.
5. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. The GUSTO investigators. N Engl J Med 1993;329:673-82.
6. Rao SV, O'Grady K, Pieper KS, et al. A comparison of the clinical impact of bleeding measured by two different classifications among patients with acute coronary syndromes. J Am Coll Cardiol 2006;47:809-16.
7. Ferguson JJ, Califf RM, Antman EM, et al; SYNERGY Trial Investigators. Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: Primary results of the SYNERGY randomized trial. JAMA 2004;292:45-54.
8. Schulman S, Keaton C; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005;3:692-4.
9. Eikelboom JW, Mehta SR, Anand SS, Xie C, Fox KA, Yusuf S. Adverse impact of bleeding on prognosis in patients with acute coronary syndromes. Circulation 2006;114:774-82.
10. Manoukian SV, Voeltz MD, Felt F, et al. Major bleeding is associated with increased 30-day mortality and ischemic complications in patients with non-ST elevation acute coronary syndromes undergoing percutaneous coronary intervention: The ACUITY trial. Am J Cardiol 2006;98(Suppl 8):45M.
11. Moscucci M, Fox KA, Cannon CP, et al. Predictors of major bleeding in acute coronary syndromes: The Global Registry of Acute Coronary Events (GRACE). Eur Heart J 2003;24:1815-23.
12. Segev A, Strauss BH, Tan M, et al; Canadian Acute Coronary Syndromes Registries Investigators. Predictors and 1-year outcome of major bleeding in patients with non-ST-elevation acute coronary syndromes: Insights from the Canadian Acute Coronary Syndrome Registries. Am Heart J 2005; 150:690-4.
13. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK; Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001;345:494-502. (Errata in 2001;345:1716, 2001;345:1506).
14. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina) (Version current at April 2, 2007).
15. Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non-Q-wave myocardial infarction. Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) Study Investigators. N Engl J Med 1998;338:1488-97. (Erratum in 1998;339:415).
16. A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Study Investigators. N Engl J Med 1998;338:1498-505.
17. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes. The PURSUIT Trial Investigators. Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression using Integrilin Therapy. N Engl J Med 1998;339:436-43.
18. Cohen M, Demers C, Gurfinkel E, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group. N Engl J Med 1997;337:447-52.
19. Antman EM, McCabe CH, Gurfinkel E, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) 11B trial. Circulation 1999;100:1593-601.
20. Goodman SG, Fitchett D, Armstrong PW, Tan M, Langer A; Integrilin and Enoxaparin Randomized Assessment of Acute Coronary Syndrome Treatment (INTERACT) Trial Investigators. Randomized evaluation of the safety and efficacy of enoxaparin versus unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes receiving the glycoprotein IIb/IIIa inhibitor eptifibatide. Circulation 2003;107:238-44.
21. Bavry AA, Kumbhani DJ, Rassi AN, Bhatt DL, Askari AT. Benefit of early invasive therapy in acute coronary syndromes: A meta-analysis of contemporary randomized clinical trials. J Am Coll Cardiol 2006;48:1319-25.
22. Mehta SR, Cannon CP, Fox KAA, et al. Routine vs selective invasive strategies in patients with acute coronary syndromes: A collaborative meta-analysis of randomized trials. JAMA 2005;293:2908-17.
23. Fox KAA, Poole-Wilson P, Clayton TC, et al. 5-year outcome of an interventional strategy in non-ST-elevation acute coronary syndrome: The British Heart Foundation RITA 3 randomised trial. Lancet 2005;366:914-20.
24. Cohen M, Demers C, Gurfinkel EP, et al. Low-molecular-weight heparins in non-ST-segment elevation ischemia: The ESSENCE trial. Efficacy and Safety of Subcutaneous Enoxaparin versus intravenous unfractionated heparin, in Non-Q-wave Coronary Events. Am J Cardiol 1998;82:19L-24L.
25. Goodman SG, Fitchett D, Armstrong PW, Tan M, Langer A; Integrilin and Enoxaparm Randomized Assessment of Acute Coronary Syndrome Treatment (INTERACT) Trial Investigators. Randomized evaluation of the safety and efficacy of enoxapann versus unfiractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes receiving the glycoprotein IIb/IIIa inhibitor eptifibatide. Circulation 2003;107:238-44.
26. Alexander KP, Chen AY, Roe MT, et al; CRUSADE Investigators. Excess dosing of antiplatelet and antithrombin agents in the treatment of non-ST-segment elevation acute coronary syndromes. JAMA 2005;294:3108-16. (Erratum in 2006;295:628).
27. Peters RJ, Mehra SR, Fox KA, et al; Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators. Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: Observations from the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) study. Circulation 2003;108:1682-7.
28. Kinnaird TD, Stabile E, Mintz GS, et al. Incidence, predictors, and prognostic implications of bleeding and blood transfusion following percutaneous coronary interventions. Am J Cardiol 2003;92:930-5.
29. Van de Werf F, Barron HV, Armstrong PW, et al; ASSENT-2 Investigators. Assessment of the Safety and Efficacy of a New Thrombolytic. Incidence and predictors of bleeding events after fibrinolytic therapy with fibrin-specific agents: A comparison of TNK-tPA and rt-PA. Eur Heart J 2001;22-.2253-61.
30. Huyhn T, Cox JL, Massel D, et al. Predictors of intracranial hemorrhage with fibrinolytic therapy in unselected community patients: A report from the FASTRAK II project. Am Heart J 2004;148:86-91.
31. Simoons ML, Maggioni AP, Knatterud G, et al. Individual risk assessment for intracranial haemorrhage during thrombolytic therapy. Lancet 1993;342:1523-8.
32. Brass LM, Lichtman JH, Wang Y, Gurwitz JH, Radford MJ, Krumbolz HM. Intracranial hemorrhage associated with thrombolytic therapy for elderly patients with acute myocardial infarction: Results from the Cooperative Cardiovascular Project. Stroke 2000;31:1802-11.
33. Giugliano RP, McCabe CH, Antman EM, et al; Thrombolysis in Myocardial Infarction (TIMI) Investigators. Lower-dose heparin with fibrinolysis is associated with lower rates of intracranial hemorrhage. Am Heart J 2001; 141:742-50.
34. Granger CB, Hirsch J, Califf RM, et al. Activated partial thromboplastin time and outcome after thrombolytic therapy for acute myocardial infarction: Results from the GUSTO-I trial. Circulation 1996;93:870-8.
35. Assessment of the Safety and Efficacy of a New Thrombolytic Regimen (ASSENT)-3 Investigators. Efficacy and safety of tenecteplase in combination with enoxaparin, abciximab, or unfractionated heparin: The ASSENT-3 randomised trial in acute myocardial infarction. Lancet 2001;358:605-13.
36. Antman EM, Morrow DA, McCabe CH, et al; ExTRACT-TIMI 25 Investigators. Enoxaparin versus unifractionated heparin as antithrombin therapy in patients receiving fibrinolysis for ST-elevation myocardial infarction. Design and rationale for the Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment-Thrombolysis In Myocardial Infarction study 25 (ExTRACT-TIMI 25). Am Heart J 2005; 149:217-26.
37. White HD, Braunwald E, Murphy SA, et al. Enoxaparin vs. unfractionated heparin with fibrinolysis for ST-elevation myocardial infarction in elderly and younger patients: Results from ExTRACT-TIMI 25. Eur Heart J 2007;28:1066-71.
38. Yusuf S, Mehta SR, Chrolavicius S, et at; OASIS-6 Trial Group. Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: The OASIS-6 randomized trial. JAMA 2006;295:1519-30.
39. Sabatine MS, Cannon CP, Gibson CM, et al; CLARITY-TIMI 28 Investigators. Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation. N Engl J Med 2005;352:1179-89.
40. Chen ZM, Jiang LX, Chen YP, et al; COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: Randomised placebo-concrolled trial. Lancet 2005;366:1607-21.
41. Rao SV, O'Grady K, Pieper KS, et al. Impact of bleeding severity on clinical outcomes among patients with acute coronary syndromes. Am J Cardiol 2005;96:1200-6.
42. Stone GW, McLaurin BT, Cox DA, et al; ACUITY Investigators. Bivalirudin for patients with acute coronary syndromes. N Engl J Med 2006;355:2203-16.
43. Hill SR, Carless PA, Henry DA, et al. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane Database Syst Rev 2002;(2);CD002042.
44. Wu WC, Rathore SS, Wang Y, Radford MJ, Krumholz HM. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 2001;345:1230-6.
45. Cohen M. Predictors of bleeding risk and long-term mortality in patients with acute coronary syndromes. Curr Med Res Opin 2005;21:439-45.
46. Stone GW, Bertrand M, Colombo A, et al. Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial: Study design and rationale. Am Heart J 2004;148:764-75.
47. Fitchett DH, Borgundvaag B, Cantor W, et al; Renewal of Non STE ACS Algorism Group. Non ST segment elevation acute coronary syndromes: A simplified risk-orientated algorithm. Can J Cardiol 2006;22:663-77.
48. Petersen JL, Mahaffey KW, Hasselblad V, et al. Efficacy and bleeding complications among patients randomized to enoxaparin or unfractionated heparin for antithrombin therapy in non-ST-segment elevation acute coronary syndromes: A systematic overview. JAMA 2004;292:89-96.
49. Neumann FJ, Kastrati A, Pogatsa-Murray G, et al. Evaluation of prolonged antithrombotic pretreatment ("cooling-off" strategy) before intervention in patients with unstable coronary syndromes: A randomized controlled trial. JAMA 2003;290:1593-9.
50. Freedman JE, Becker RC, Adams JE, et al; American Heart Association. Council on Clinical Cardiology Subcommittee on Acute Cardiac Care, Council on Cardiopulmonary and Critical Care, Council on Cardiovascular Nursing, and Council on Stroke. Medication errors in acute cardiac care: An American Heart Association scientific statement from the Council on Clinical Cardiology Subcommittee on Acute Cardiac Care, Council on Cardiopulmonary and Critical Care, Council on Cardiovascular Nursing, and Council on Stroke. Circulation 2002;106:2623-9.
51. Eikelboom JW, Quinlan DJ, Mehta SR, Turpie AG, Menown IB, Yusuf S. Unfractionated and low-molecular-weight heparin as adjuncts to thrombolysis in aspirin-treated patients with ST-elevation acute myocardial infarction: A meta-analysis of the randomized trials. Circulation 2005;112:3855-67.
52. Grand'Maison A, Charest AF, Geerts WH. Anticoagulant use in patients with chronic renal, impairment. Am J Cardiovasc Drugs 2005;5:291-305.
53. Derry S, Loke YK. Risk of gastrointestinal haemorrhage with long term use of aspirin: Meta-analysis. BMJ 2000;321:1183-7.
54. Hallas J, Dall M, Andries A, et al. Use of single and combined antithrombotic therapy and risk of serious upper gastrointestinal bleeding: Population based case-control study. BMJ 2006;333:726-8.
55. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71-86. (Erratum in 2002;324:141).
56. Laine L. Approaches to nonsteroidal anti-inflammatory drug use in the high-risk patient. Gastroenterology 2001;120:594-606.
57. Kelly JP, Kaufman DW, Jurgelon JM, Sheehan J, Koff RS, Shapiro S. Risk of aspirin-associated major upper-gastrointestinal bleeding with enteric-coated or buffered product. Lancet 1996;348:1413-6.
58. Yeomans ND, Tulassay Z, Juhasz L, et al. A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs. Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-associated Ulcer Treatment (ASTRONAUT) Study Group. N Engl J Med 1998;338:719-26.
59. Chan FK. Management of high-risk patients on non-steroidal anti-inflammatory drugs or aspirin. Drugs 2006;66(Suppl 1):23-28.
60. MICHELANGELO OASIS-5 Steering Committee; Mehta SR, Yusuf S, Granger CB, et al. Design and rationale of the MICHELANGELO Organization to Assess Strategies in Acute Ischemic Syndromes (OASIS)-5 trial program evaluating fondaparinux, a synthetic factor Xa inhibitor, in patients with non-ST-segment elevation acute coronary syndromes. Am Heart J 2005;150:1107.
61. Cohen M, Theroux P, White HD. Anti-thrombotic combination using tirofiban and enoxaparin: The ACUTE II study. Circulation 2000; 102:II-826.
62. Blazing MA, de Lemos JA, White HD, et al. Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: A randomized controlled trial. JAMA 2004;292:55-64. (Erratum in 2004;292:1178).
63. Caims J, Gent M, Singer J, et al. Aspirin, sulfinpyrazone, or both in unstable angina. Results of a Canadian multicenter trial. N Engl J Med 1985;313:1369-75.
64. Randomised placebo-controlled trial of abciximab before and during coronary intervention in refractory unstable angina: The CAPTURE Study. Lancet 1997;349:1429-35. (Erratum in 1997;350:744).
65. Low-molecular-weight heparin during instability in coronary artery disease, Fragmin during Instability in Coronary Artery Disease (FRISC) study group. Lancet 1996;347:561-8.
66. Ferguson JJ, Califf RM, Antman EM, et al; SYNERGY Trial Investigators. Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial. JAMA 2004;292:45-54.
67. Antman EM, Morrow DA, McCabe CH, et al; ExTRACT-TIMI 25 Investigators. Enoxaparin versus unfractionated heparin with fibrinolysis for ST-elevation myocardial infarction. N Engl J Med 2006;354:1477-88.