Hemorrhagic complications after prasugrel (Effient) therapy for vascular neurointerventional procedures
Key result
Dual antiplatelet therapy with aspirin/prasugrel was associated with a higher rate of hemorrhagic complications during neurointerventional surgery compared with aspirin/clopidogrel (19.4% vs 3.6%; p=0.02).
Why the study?
Does DAPT with aspirin and prasugrel increase hemorrhagic complications compared to aspirin and clopidogrel in patients undergoing neurointerventional surgery?
Population
76 patients undergoing neurointerventional surgery by a single interventionalist over a 20 month period.
Comparison
Dual antiplatelet therapy with aspirin and… vs Dual antiplatelet therapy with aspirin and…
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
May increase hemorrhage risk with prasugrel DAPT; leaves open need for prospective trials before wider adoption.
Study Design
Type
Cohort (n=76)
Multicenter
No
Structured PICO
Does DAPT with aspirin and prasugrel increase hemorrhagic complications compared to aspirin and clopidogrel in patients undergoing neurointerventional surgery?
P
Population
76 patients undergoing 86 neurointerventional procedures by a single interventionalist over a 20-month period, receiving dual antiplatelet therapy with either aspirin/clopidogrel or aspirin/prasugrel.
E
Exposure
Dual antiplatelet therapy (DAPT) with aspirin and prasugrel (administered to identified clopidogrel non-responders)
C
Comparator
Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel
O
Outcome
Hemorrhagic complicationssafety
Main Result
Absolute Event Rate: 19.4% vs 3.6%
p-value: p=0.02
In patients undergoing neurointerventional surgery, DAPT with aspirin and prasugrel was associated with a significantly higher rate of hemorrhagic complications compared to aspirin and clopidogrel.
Cite This Study
Akbari et al. (2012) conducted a cohort in Neurointerventional surgery (n=76). Aspirin/prasugrel vs. Aspirin/clopidogrel was evaluated on Hemorrhagic complications (p=0.02). Dual antiplatelet therapy with aspirin/prasugrel was associated with a higher rate of hemorrhagic complications during neurointerventional surgery compared with aspirin/clopidogrel (19.4% vs 3.6%; p=0.02).