Details

Autor(en) / Beteiligte

• Grobost, Vincent
• Hammi, Sami
• Pereira, Bruno
• Guilhem, Alexandre
• Duffau, Pierre
• Seguier, Julie
• Parrot, Antoine
• Gautier, Giovanni
• Alric, Laurent
• Kerjouan, Mallorie
• Le Guillou, Xavier
• Simon, Delphine
• Chaussavoine, Laurent
• Rondeau-Lutz, Murielle
• Leguy-Seguin, Vanessa
• Delagrange, Laura
• Lavigne, Christian
• Maillard, Hélène
• Dupuis-Girod, Sophie

Titel

Antiplatelet and anticoagulant therapies in hereditary hemorrhagic telangiectasia: A large French cohort study (RETROPLACOTEL)

Ist Teil von

• Thrombosis research, 2023-09, Vol.229, p.107-113

Ort / Verlag

United States: Elsevier Ltd

Erscheinungsjahr

2023

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• It is unclear whether hereditary hemorrhagic telangiectasia (HHT) patients can tolerate antithrombotic therapies (AT) including antiplatelet (AP) and/or anticoagulant (AC) agents. Primary endpoint was tolerance to AT in HHT. Secondary endpoints were to identify factors associated with major bleeding events (MBE) and premature discontinuation of AT. Retrospective multicenter study in French national HHT Registry patients exposed to AT. We included 126 patients with 180 courses of AT. Median follow-up was 24 [11–52] months. Mean age was 65.6 ± 13.1 years. The first 3 months of AT exposure had an increased risk of hospitalization for hemorrhage (p < 0.001) and transfusions (p < 0.001). MBE (n = 63) occurred more frequently in the first 3 months of AT exposure (p < 0.001). Premature discontinuation of AT occurred in 61 cases. Rate of premature discontinuation was 29 % under both AP and AT therapy but significantly higher under dual AP therapy (n = 4/7, 57 % p = 0.008). Risk factors for MBE were: age ≥ 60 years (HR 2.34 [1.12;4.87], p = 0.023), prior hospitalization in the 3 months before starting AT for hemorrhage (HR 3.59 [1.93;6.66], p < 0.001) or transfusion (HR 3.15 [1.61;6.18], p = 0.001), previous history of gastro-intestinal bleeding (HR 2.71 [1.57;4.65], p < 0.001) or MBE (HR 4.62 [2.68;7.98], p < 0.001). Frequency of MBE did not differ between groups except for a higher risk in the dual AP group (HR 3.92 [1.37;11.22], p = 0.011). Tolerance of AC or AP therapy was similar in HHT population but not dual AP therapy. We identified risk factors for MBE occurrence or premature discontinuation under AT. •Similar tolerability of antiplatelet and anticoagulant therapies in HHT•Dual antiplatelet therapy is not tolerated in HHT and should be avoided•Risk factors in HHT patients for major bleeding events (MBE) occurrence or premature discontinuation under antithrombotics are ≥60 years old, previous history of MBE or gastrointestinal bleeding, hospitalizations for bleeding in the last 3 months to help guide clinicians prescribing antithrombotic medication•Direct oral anticoagulants, notably apixaban, appear well tolerated by HHT patients