Nuisance bleeding tied to early increase in bleeding risk in patients with acute MI on DAPT: Circulation
Korea: A subanalysis of the TALOS-AMI trial has shown nuisance bleeding (NB) to be frequent in patients with acute myocardial infarction (AMI) on 1-month ticagrelor-based dual antiplatelet therapy (DAPT) and tied with an early increase in bleeding.
"De-escalation of DAPT by switching to clopidogrel after nuisance bleeding may lower bleeding without increasing the odds of major adverse cardiovascular events (MACE)," Eun Ho Choo and colleagues wrote in their study published in Circulation: Cardiovascular Interventions.
There needs to be more data regarding management and prognosis after nuisance bleeding. Considering this, the research team aimed to investigate the prognostic significance of nuisance bleeding in patients receiving potent DAPT after AMI. They also assessed the impact of DAPT's de-escalation on clinical outcomes after that.
The researchers used 2583 patients from the Ticagrelor Versus Clopidogrel in Stabilized Patients With Acute Myocardial Infarction (TALOS-AMI trial) to examine the clinical impact of NB during 1-month treatment with ticagrelor-based DAPT following AMI. They also discussed the effects of de-escalation to clopidogrel in participants with or without nuisance bleeding. Nuisance bleeding was defined as BARC (Bleeding Academic Research Consortium) 1 bleeding). The association between NB within one month and BARC 2, 3, or 5 bleeding and MACE (a composite of myocardial infarction, cardiovascular death, and stroke) was assessed from 1 through 12 months.
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