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Antiplatelet Drugs and Risk of Bleeding After Bedside Pleural Procedures: A National Multicenter Cohort Study
Laurence Dangers1, Jonathan Giovannelli2, Gilles Mangiapan3
1AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), Paris, France; Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.
Chest
|December 8, 2020
Summary
Patients on antiplatelet therapy have a higher risk of bleeding after pleural procedures. This includes a greater chance of serious bleeding events, necessitating careful consideration in clinical guidelines.
Area of Science:
- Cardiology
- Pulmonology
- Clinical Pharmacology
Background:
- Decision-making regarding antiplatelet therapy before pleural procedures balances bleeding risk against thrombosis risk.
- Current knowledge on the specific bleeding risk associated with antiplatelet drugs post-pleural procedures is limited.
Purpose of the Study:
- To investigate whether antiplatelet drug use increases the risk of bleeding following pleural procedures.
Main Methods:
- A French multicenter cohort study involving 19 centers.
- Patients were categorized into those receiving antiplatelet therapy and a control group.
- Bleeding events (hematoma, hemoptysis, hemothorax) within 24 hours were the primary outcome, with serious bleeding defined by transfusion, respiratory support, or death.
Main Results:
- A total of 1,124 patients were analyzed (182 on antiplatelet therapy).
- The 24-hour bleeding incidence was 3.23% in the antiplatelet group versus 0.96% in the control group.
- Antiplatelet therapy significantly increased the risk of both bleeding events (OR 4.13) and serious bleeding (OR 7.27) after adjusting for confounding factors.
Conclusions:
- Antiplatelet therapy is associated with a significantly higher risk of bleeding and serious bleeding post-pleural procedures.
- These findings should inform future clinical guidelines to enhance patient safety during pleural interventions.
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