Prevalence of bleeding in patients on single or dual antiplatelet therapy combined with vitamin K antagonists or direct oral anticoagulants

Abstract

Background

Patients with atrial fibrillation often require anticoagulation therapy to prevent stroke and thromboembolism. However, anticoagulants can have serious side effects, such as bleeding, particularly when combined with antiplatelet therapy.

Objective

The aim of this study is to estimate the prevalence of major bleeding in patients receiving either dual or triple antithrombotic therapy.

Method

This study is a single-center retrospective chart review utilizing the hospital electronic health record. The prevalence and percentage of bleeding events were reported for each antithrombotic regimen.

Results

Of the 539 patients receiving oral anticoagulants, 202 were using oral anticoagulants in combination with either single or dual antiplatelet therapy. Out of 35 patients using triple antithrombotic therapy, four (11.4%) experienced major bleeding. Based on the analysis of 73 patients using anticoagulants in combined with clopidogrel, the results showed that one patient (1.3%) suffered bleeding. Among the 94 patients treated with anticoagulants plus aspirin, seven (7.4%) experienced major bleeding events.

Conclusion

The combination of anticoagulants and antiplatelet agents is associated with an elevated bleeding risk. Patients receiving triple antithrombotic therapy experience high prevalence of bleeding. Nonetheless, the group receiving anticoagulant and clopidogrel alone exhibited low prevalence of bleeding risk.