Early Post-Discharge Bleeding and Antiplatelet Therapy Discontinuation Among Acute Myocardial Infarction Patients Treated With Percutaneous Coronary Intervention

• Published in: Journal of the American College of Cardiology 2014-04, Vol.63 (16), p.1700-1702
• Main Authors: Wang, Tracy Y., MD, MHS, MSc, McCoy, Lisa, MS, Henry, Timothy D., MD, Effron, Mark B., MD, Messenger, John C., MD, Cohen, David J., MD, MSc, Mark, Daniel B., MD, MPH, Stone, Gregg W., MD, Zettler, Marjorie, PhD, MPH, Singh, Mandeep, MD, Fonarow, Gregg C., MD, Peterson, Eric D., MD, MPH
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Cardiology; Cardiovascular; Confidence intervals; Drug therapy; Follow-Up Studies; Heart attacks; Hemorrhage - chemically induced; Hemorrhage - epidemiology; Humans; Incidence; Internal Medicine; Mortality; Myocardial Infarction - therapy; Patient Discharge; Percutaneous Coronary Intervention; Platelet Aggregation Inhibitors - adverse effects; Platelet Aggregation Inhibitors - therapeutic use; Randomized Controlled Trials as Topic; Survival Rate - trends; Time Factors; United States - epidemiology; Withholding Treatment
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2013.12.012

In our study, patients who did not have a follow-up outpatient appointment arranged before discharge were less likely to report their bleeding event to a clinician. [...]ensuring early clinical follow-up--particularly for patients at higher risk of bleeding (e.g., women, lower baseline functional status, discharge on a second-generation ADPri regimen, or concurrent oral anticoagulant prescription)--might be a key first step in both raising subsequent bleeding events to clinical attention and avoiding premature ADPri discontinuation. [...]bleeding occurs commonly in the early period after discharge among MI patients treated with PCI and ADPris and is not always brought to clinical attention.