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Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis.

Publication ,  Journal Article
Lieber, SR; Jiang, Y; Moon, A; Barritt, AS
Published in: Journal of clinical gastroenterology
August 2022

In an aging population with cardiovascular comorbidities, anticoagulant (AC), antiplatelet (AP), and nonsteroidal anti-inflammatory drug (NSAID) use are increasing. It remains unclear whether these agents pose increased bleeding risk in cirrhosis. This study aimed to assess the association between these medications and bleeding and portal hypertension complications in cirrhosis.The IMS PharMetrics database was used to identify privately insured adults diagnosed with cirrhosis from 2007 to 2015, stratified as compensated or decompensated based on the presence of portal hypertensive complications 1 year before cirrhosis diagnosis. Bleeding or decompensation outcomes were assessed 6 to 18 months after cirrhosis diagnosis using a landmark analysis design. Multivariable Cox proportional hazards regression modeling assessed associations between AC, AP, and NSAID drug exposures and outcomes adjusting for covariates.A total of 18,070 cirrhosis patients were analyzed; 57% male; 74% ages 50 to 64 years; 34% with a prior decompensation. Overall, 377 (2%) had claims for ACs; 385 (2%) APs; and 1231 (7%) NSAIDs. APs were associated with increased bleeding [adjusted hazard ratio (aHR)=1.31; 95% confidence interval (CI): 1.00, 1.72] and decompensation events (aHR=1.44; 95% CI: 1.06, 1.95) in a 9-month landmark analysis. NSAIDs were significantly associated with bleeding events (aHR=1.29; 95% CI: 1.06, 1.57) on 3-month landmark analysis. No statistically significant associations were seen between ACs and bleeding or decompensation outcomes in adjusted analyses.AP use was associated with increased bleeding and decompensation events among privately insured patients with cirrhosis. NSAID use was associated with significant early bleeding, but not decompensations. Lastly ACs were not associated with bleeding or decompensation outcomes.

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Published In

Journal of clinical gastroenterology

DOI

EISSN

1539-2031

ISSN

0192-0790

Publication Date

August 2022

Volume

56

Issue

7

Start / End Page

627 / 634

Related Subject Headings

  • Platelet Aggregation Inhibitors
  • Middle Aged
  • Male
  • Liver Cirrhosis
  • Hypertension, Portal
  • Humans
  • Hemorrhage
  • Gastroenterology & Hepatology
  • Female
  • Anticoagulants
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lieber, S. R., Jiang, Y., Moon, A., & Barritt, A. S. (2022). Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis. Journal of Clinical Gastroenterology, 56(7), 627–634. https://doi.org/10.1097/mcg.0000000000001558
Lieber, Sarah R., Yue Jiang, Andrew Moon, and Alfred S. Barritt. “Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis.Journal of Clinical Gastroenterology 56, no. 7 (August 2022): 627–34. https://doi.org/10.1097/mcg.0000000000001558.
Lieber SR, Jiang Y, Moon A, Barritt AS. Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis. Journal of clinical gastroenterology. 2022 Aug;56(7):627–34.
Lieber, Sarah R., et al. “Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis.Journal of Clinical Gastroenterology, vol. 56, no. 7, Aug. 2022, pp. 627–34. Epmc, doi:10.1097/mcg.0000000000001558.
Lieber SR, Jiang Y, Moon A, Barritt AS. Antiplatelet Medications Are Associated With Bleeding and Decompensation Events Among Patients With Cirrhosis. Journal of clinical gastroenterology. 2022 Aug;56(7):627–634.

Published In

Journal of clinical gastroenterology

DOI

EISSN

1539-2031

ISSN

0192-0790

Publication Date

August 2022

Volume

56

Issue

7

Start / End Page

627 / 634

Related Subject Headings

  • Platelet Aggregation Inhibitors
  • Middle Aged
  • Male
  • Liver Cirrhosis
  • Hypertension, Portal
  • Humans
  • Hemorrhage
  • Gastroenterology & Hepatology
  • Female
  • Anticoagulants