National Estimates of Emergency Department Visits for Hemorrhage-Related Adverse Events From Clopidogrel Plus Aspirin and From Warfarin

Shehab, Nadine; Sperling, Laurence; Kegler, Scott R.; Budnitz, Daniel S.

doi:10.1001/archinternmed.2010.407

Cited by 96 publications

(63 citation statements)

References 43 publications

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“…All our patients underwent a dual antiplatelet therapy during 3 months that was continued as a monotherapy for 3 more months. Dual antiaggregation is known to increase the risk of general hemorrhagic complications 15 ; in particular, the occurrence of cerebral bleeding appears in correlation with the level of platelet inhibition. 16 Fortunately, none of our patients sustained delayed cerebral hemorrhagic events.…”

Section: Discussionmentioning

confidence: 99%

Flow Diverters at and Beyond the Level of the Circle of Willis for the Treatment of Intracranial Aneurysms

Pistocchi

Blanc

Bartolini

et al. 2012

Stroke

181

119

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Section: Discussionmentioning

confidence: 99%

Flow Diverters at and Beyond the Level of the Circle of Willis for the Treatment of Intracranial Aneurysms

Pistocchi

Blanc

Bartolini

et al. 2012

Stroke

181

119

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“…Furthermore, previous studies have shown that the rate of spontaneous acute bleeding events resulting in hospitalization secondary to antiplatelet therapy was not significantly different compared with warfarin, especially GI bleeding. 13 …”

Section: Discussionmentioning

confidence: 99%

Initial Experience With High-Risk Patients Excluded From Clinical Trials

Barakat

Hussein

Saliba

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background— The implantation of left atrial appendage closure device (WATCHMAN, Boston Scientific, Natick, MA) is an alternative option to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation. Patients require short-term OAC after implantation to avoid device thrombosis. The 2 clinical trials that assessed this device excluded patients thought not to be candidates for OAC. As such, little is known about the safety of this strategy in patients with previous major bleeding events. Methods and Results— All 20 consecutive patients with history of spontaneous major bleeding while on OAC who had subsequently undergone WATCHMAN device implantation at our institution were included. A newly conceived multidisciplinary Atrial Fibrillation Stroke Prevention Center evaluated patients for candidacy for device implantation and subsequent antithrombotic therapy. The primary outcome was spontaneous major bleeding while receiving short-term postprocedural OAC. Median CHA 2 DS 2 -VASc and HAS-BLED scores were 5 (quartiles 5–6) and 5 (quartiles 4–5), respectively. Previous major bleeding events were major gastrointestinal bleeding, intracranial bleeding, spontaneous hemopericardium with cardiac tamponade, and hemarthrosis in 11, 7, 1, and 1 patients, respectively. None of the patients had spontaneous major bleeding during the course of OAC after device implantation. In 1 patient, OAC was discontinued after 40 days because of mechanical fall with head trauma resulting in subdural hematoma with no associated neurological deficits; this was managed conservatively. Conclusions— With careful multidisciplinary evaluation, a short course of OAC after WATCHMAN device implantation in patients with previous spontaneous major bleeding events is associated with low risk of recurrent spontaneous major bleeding.

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“…Not surprisingly, some of the most commonly reported drug-associated adverse events are warfarin related. 2 An important part of interindividual dose variability arises from variation in 2 genes, CYP2C9 and VKORC1. These genes are associated with the pharmacokinetics (affecting drug metabolism) and pharmacodynamics (affecting drug target) of warfarin, respectively.…”

Section: Historical Considerationsmentioning

confidence: 99%

Using Pharmacogenetics in Real Time to Guide Warfarin Initiation

Carlquist

Anderson

2011

Circulation

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National Estimates of Emergency Department Visits for Hemorrhage-Related Adverse Events From Clopidogrel Plus Aspirin and From Warfarin

Abstract: These findings indicate that the acute hemorrhagic risk with DAT is clinically significant and reinforce the importance of practitioners and patients recognizing and anticipating this risk.

Cited by 96 publications

References 43 publications

Flow Diverters at and Beyond the Level of the Circle of Willis for the Treatment of Intracranial Aneurysms

Flow Diverters at and Beyond the Level of the Circle of Willis for the Treatment of Intracranial Aneurysms

Initial Experience With High-Risk Patients Excluded From Clinical Trials

Using Pharmacogenetics in Real Time to Guide Warfarin Initiation

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