Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study

The Lancet

Volumn 390, Issue 10093, 2017, Pages 490-499

  Li, Linxin ^a   Geraghty, Olivia C ^a   Mehta, Ziyah ^a   Rothwell, Peter M ^a  

^a UNIVERSITY OF OXFORD   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; CLOPIDOGREL; DIPYRIDAMOLE; ANTITHROMBOCYTIC AGENT; PROTON PUMP INHIBITOR;

ADULT; ANTICOAGULANT THERAPY; ARTICLE; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; COHORT ANALYSIS; CONTROLLED STUDY; DISEASE SEVERITY; EPISTAXIS; FEMALE; FOLLOW UP; HEART INFARCTION; HOSPITAL ADMISSION; HUMAN; KAPLAN MEIER METHOD; LONG TERM CARE; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; NUMBERS NEEDED TO TREAT; OUTCOME ASSESSMENT; POPULATION BASED CASE CONTROL STUDY; PRIORITY JOURNAL; PROSPECTIVE STUDY; RISK FACTOR; SECONDARY PREVENTION; SUBARACHNOID HEMORRHAGE; SUBDURAL HEMATOMA; TRANSIENT ISCHEMIC ATTACK; UNSTABLE ANGINA PECTORIS; UPPER GASTROINTESTINAL BLEEDING; AGE; AGE DISTRIBUTION; AGED; BLEEDING; CHEMICALLY INDUCED; ENGLAND; GASTROINTESTINAL HEMORRHAGE; INCIDENCE; PROCEDURES; RISK ASSESSMENT; SEVERITY OF ILLNESS INDEX; VASCULAR DISEASE; VERY ELDERLY;

AGE DISTRIBUTION; AGE FACTORS; AGED; AGED, 80 AND OVER; ASPIRIN; COHORT STUDIES; ENGLAND; FEMALE; GASTROINTESTINAL HEMORRHAGE; HEMORRHAGE; HUMANS; INCIDENCE; MALE; MIDDLE AGED; PLATELET AGGREGATION INHIBITORS; PROTON PUMP INHIBITORS; RISK ASSESSMENT; RISK FACTORS; SECONDARY PREVENTION; SEVERITY OF ILLNESS INDEX; VASCULAR DISEASES;

EID: 85020692248     PISSN: 01406736     EISSN: 1474547X     Source Type: Journal    
DOI: 10.1016/S0140-6736(17)30770-5     Document Type: Article

References (36)

1. Williams, CD, Chan, AT, Elman, MR, et al. Aspirin use among adults in the U.S. Results of a national survey. Am J Prev Med 48 (2015), 501–508.
2. Elwood, P, Morgan, G, White, J, et al. Aspirin taking in a south Wales county. Br J Cardiol 18 (2011), 238–240.
3. Kernan, WN, Ovbiagele, B, Black, HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 45 (2014), 2160–2236.
4. Smith, SC Jr, Allen, J, Blair, SN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 113 (2006), 2363–2372.
5. Antithrombotic Trialists' (ATT) Collaboration, Baigent, C, Blackwell, L, Collins, R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373 (2009), 1849–1860.
6. Mo, C, Sun, G, Lu, ML, et al. Proton pump inhibitors in prevention of low-dose aspirin-associated upper gastrointestinal injuries. World J Gastroenterol 21 (2015), 5382–5392.
7. Moayyedi, P, Leontiadis, GI, The risks of PPI therapy. Nat Rev Gastroenterol Hepatol 9 (2012), 132–139.
8. Gomm, W, von Holt, K, Thome, F, et al. Association of proton pump inhibitors with risk of dementia: a pharmacoepidemiological claims data analysis. JAMA Neurol 73 (2016), 410–416.
9. Merino, EM, Johansson, S, Nagy, P, Rodriguez, LA, Effect of baseline gastrointestinal risk and use of proton pump inhibitors on frequency of discontinuation of aspirin for secondary cardiovascular prevention in United Kingdom primary care. Am J Cardiol 112 (2013), 1075–1082.
10. De Jong, HJI, Korevaar, JC, van Dijk, L, Voogd, E, can Dijk, CE, van Oijen, MGH, Suboptimal prescribing of proton-pump inhibitors in low-dose aspirin users: a cohort study in primary care. BMJ Open, 3, 2013 pii:e003044.
11. Rothwell, PM, Price, JF, Fowkes, FG, et al. Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet 379 (2012), 1602–1612.
12. Bhatt, DL, Scheiman, J, Abraham, NS, et al. ACCF/ACG/AHA 2008 expert consensus focument on reducing the gastrointerinal risks of antiplatelet therapy and NSAID use. Circulation 118 (2008), 1891–1909.
13. Cea Soriano, L, Rodriguez, LA, Risk of upper gastrointestinal bleeding in a cohort of new users of low-dose ASA for secondary prevention of cardiovascular outcomes. Front Pharmacol, 1, 2010, 126.
14. Sørensen, R, Hansen, ML, Abildstrom, SZ, et al. Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data. Lancet 374 (2009), 1967–1974.
15. Asberg, S, Henriksson, KM, Farahmand, B, Terent, A, Hemorrhage after ischemic stroke—relation to age and previous hemorrhage in a nationwide cohort of 58 868 patients. Int J Stroke 8 (2013), 80–86.
16. Hernandez-Diaz, S, Garcia, Rodriguez LA, Cardioprotective aspirin users and their excess risk of upper gastrointestinal bcomplications. BMC Med, 4, 2006, 22.
17. Rothwell, PM, Coull, AJ, Silver, LE, et al. Population-based study of event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). Lancet 366 (2005), 1773–1783.
18. van Swieten, J, Koudstaal, P, Visser, M, et al. Interobserver agreement for the assessement of handicap in stroke patients. Stroke 19 (1988), 604–607.
19. Yusuf, S, Zhao, F, Mehta, SR, et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345 (2001), 494–502.
20. Ducrocq, G, Wallace, JS, Baron, G, et al. Risk score to predict serious bleeding in stable outpatients with or at risk of atherothrombosis. Eur Heart J 31 (2010), 1257–1265.
21. Altman, DG, Andersen, PK, Calculating the number needed to treat for trials where the outcome is time to an event. BMJ 319 (1999), 1492–1495.
22. Lovelock, CE, Molyneux, AJ, Rothwell, PM, on behalf of the Oxford Vascular Study. Change in incidence and aetiology of intracerabral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study. Lancet Neurol 6 (2007), 487–493.
23. Abraham, NS, Hartman, C, Richardson, P, Castillo, D, Street, RL Jr, Naik, AD, Risk of lower and upper gastrointestinal bleeding, transfusions, and hospitalizations with complex antithrombotic therapy in elderly patients. Circulation 128 (2013), 1869–1877.
24. Greenwald, DA, Aging, the gastrointestinal tract, and risk of acid-related disease. Am J Med 117:suppl 5A (2004), 8S–13.
25. Yang, X, Alexander, KP, Chen, AY, et al. 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 46 (2005), 1490–1495.
26. Soriano, LC, Bueno, H, Lanas, A, Rodriguez, LAG, Cardiovascular and upper gastrointestinal bleeding consequences of low-dose acetylsalicylic acid discontinuation. Thromb Haemost 110 (2013), 1298–1304.
27. Biondi-Zoccai, GGL, Lotrionte, M, Agostoni, P, et al. A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50 279 patients at risk for coronary artery disease. Eur Heart J 27 (2006), 2667–2674.
28. Sung, JJY, Lau, JYW, Ching, JYL, et al. Continuation of low-dose aspirin therapy in peptic ulcer bleeding. A randomized trial. Ann Intern Med 152 (2010), 1–9.
29. Dumbleton, JS, Avery, AJ, Coupland, C, et al. The Helicobacter Eradication Aspirin Trial (HEAT): a large simple randomised controlled trial using novel methodology in primary care. Ebiomedicine 2 (2015), 1200–1204.
30. Garcia, Rodriguez LA, Martin-Perez, M, Hennekens, CH, Rothwell, PM, Lanas, A, Bleeding risk with long-term low-dose aspirin: a systematic review of observational studies. PLoS One, 11, 2016, e0160046.
31. Rothwell, PM, Algra, A, Chen, Z, Diener, HC, Norrving, B, Mehta, Z, Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials. Lancet 388 (2016), 365–375.
32. Steinhubl, SR, Kastrati, A, Berger, PB, Variation in the definitions of bleeding in clinical trials of patients with acute coronary syndromes and undergoing percutaneous coronary interventions and its impact on the apparent safety of antithrombotic drugs. Am Heart J 154 (2007), 3–11.
33. McQuaid, KR, Laine, L, Systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials. Am J Med 119 (2006), 624–638.
34. Othman, F, Crooks, CJ, Card, TR, Community acquired pneumonia incidence before and after proton pump inhibitor prescription: population based study. BMJ, 355, 2016, i5813.
35. Lambert, AA, Lam, JO, Paik, JJ, Ugarte-Gil, C, Drummond, MB, Crowell, TA, Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis. PLoS One, 10, 2015, e0128004.
36. Park, CH, Kim, EH, Roh, YH, Kim, HY, Lee, SK, The association between the use of proton pump inhibitors and the risk of hypomagnesemia: a systematic review and meta-analysis. PLoS One, 9, 2014, e112558.