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Anticoagulant plus antiplatelet treatment increased the risk of bleeding in atrial fibrillation

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 Q What is the effect of concomitant anticoagulant and antiplatelet treatment on the risk of major bleeding in older patients with atrial fibrillation (AF)?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Internal medicine ★★★★★★☆ Haematology ★★★★★☆☆ Cardiology ★★★★★☆☆


Embedded ImageDesign:

retrospective cohort analysis within the US National Stroke Project.

Embedded ImageSetting:


Embedded ImagePatients:

10 093 patients ⩾65 years of age (mean age 77 y, 51% men) who were admitted to hospital for AF and had warfarin discharge treatment. Exclusion criteria: transfer to another acute care hospital, death during hospitalisation, or discharge against hospital advice.

Embedded ImageRisk factors:

age, sex, comorbid conditions (coronary or valvular heart disease, diabetes, previous cerebrovascular event, hypertension, and congestive heart failure), bleeding risk factors (previous bleeding, anaemia during the index hospital admission, ulcer, risk of falls, alcohol use, hepatic disease, dementia, cancer, and concurrent medications), and warfarin use before admission.

Embedded ImageOutcomes:

antiplatelet drug use after hospital discharge and hospital …

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