Why the study?
Clinical guidelines and public health authorities lack recommendations on scalable approaches to defining and monitoring the occurrence and severity of bleeding in populations prescribed antithrombotic therapy.
Does antithrombotic therapy increase bleeding risk and what is the prognostic impact of bleeding in patients with newly diagnosed cardiovascular disease?
Population
128,815 patients with newly diagnosed AF, acute MI, unstable angina, or stable angina in England
Comparison
Bleeding events vs no bleeding
Design
Linked electronic health record cohort study
Key result
Hospitalised bleeding without markers of severity was associated with an increased risk of all-cause mortality (HR 1.99) compared to no bleeding in patients with cardiovascular disease.
Authors
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May indicate rising bleeding risk with antithrombotic regimens over time; leaves open drivers and mitigation strategies.
Cohort (n=128,815)
Yes
Does antithrombotic therapy increase bleeding risk and what is the prognostic impact of bleeding in patients with newly diagnosed cardiovascular disease?
Hazard Ratio: 1.99 (95% CI 1.92–2.05)
Bleeding affects one in four cardiovascular disease patients prescribed antithrombotic therapy and is associated with a significantly increased risk of all-cause mortality and atherothrombotic events.
Pasea et al. (2019) conducted a cohort in Atrial fibrillation, acute myocardial infarction, unstable angina, or stable angina (n=128,815). Hospitalised bleeding without markers of severity vs. No bleeding was evaluated on All-cause mortality (HR 1.99, 95% CI 1.92, 2.05). Hospitalised bleeding without markers of severity was associated with an increased risk of all-cause mortality (HR 1.99) compared to no bleeding in patients with cardiovascular disease.