Barriers of antiaggregant treatment

Rev Med Chir Soc Med Nat Iasi. 2014 Apr-Jun;118(2):333-8.

Abstract

In the present study we aimed to evaluate side effects of antiplatelet therapy in order to establish correlations with medication type, doses and association with other therapies.

Material and methods: In the study we prospectively evaluated a cohort of patients who received antiplatelet therapy for different pathologies. We included patients with acute coronary syndromes, valvular disease complicated with supraventricular arrhythmias (especially atrial fibrillation), carotidal critical stenosis, neurologic disease (ischemic or thrombotic), and peripheral artery disease.

Results and discussions: The study included 125 patients (85 males and 40 females), aged between 45 and 85, and admitted in the 1st Cardiology Department, St Spiridon Hospital, between January 2012 and December 2013, who received antiplatelet therapy for different pathologies. All the patients included in the study received platelet antiaggregant therapy with Clopidogrel in association or not with Aspirin or low weight molecular heparin. Side effects reported (possibly correlated with antiplatelet therapy) were: macroscopic hematuria (7 cases), cutaneous ecchymosis (7 cases), purpuric lesions (9 cases), gingival bleeding (12 cases), upper gastrointestinal bleeding (6 cases), and hemoptysis (2 cases).

Conclusions: Hemorrhagic events under the treatment with antiplatelet agents are rare in comparison with the large number of patients treated. Clinical manifestations are very different depending on the drug and also on the drug-associations used. Hemorrhagic accidents may sometimes be very serious, determining the specific therapeutic measures.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Aspirin / adverse effects*
  • Aspirin / therapeutic use
  • Clopidogrel
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Heart Diseases / drug therapy
  • Hemorrhage / chemically induced*
  • Heparin / adverse effects*
  • Heparin / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / drug therapy
  • Peripheral Arterial Disease / drug therapy
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / therapeutic use
  • Time Factors

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Heparin
  • Clopidogrel
  • Ticlopidine
  • Aspirin