Bleeding

Long-term ticagrelor monotherapy after PCI lowered risk for bleeding compared with 1-year dual antiplatelet therapy followed by 1-year aspirin monotherapy in patients with ACS, but not for those with CAD.

Compared with urgent endoscopy and late endoscopy, early endoscopy correlated with better outcomes among patients presenting with acute upper gastrointestinal bleeding, according to research published in Gut.

Dual antiplatelet therapy for 1 month vs. 3 or more months in patients at high bleeding risk who had PCI with a biodegradable-polymer sirolimus-eluting stent (Ultimaster, Terumo).

Patients who continued to use anticoagulant therapy beyond the initial 3 to 6 months of treatment for a first unprovoked venous thromboembolism were at “considerable” risk for major bleeding, researchers wrote.

In patients with acute MI, upper gastrointestinal bleeding occurred in 1.5% within 1 year and was associated with poor outcomes, researchers reported at the European Society of Cardiology Congress.

In patients at high bleeding risk, dual antiplatelet therapy for 1 month after PCI lowered bleeding rates and was noninferior for ischemic events compared with 3-month DAPT, according to results of the MASTER DAPT trial.

In a meta-analysis, researchers observed that severe direct oral anticoagulant-related bleeding death was relatively frequent, despite treatment with reversal agents, and that achieving hemostasis greatly improved survival.

Among patients at high ischemic and bleeding risk, longer duration of dual antiplatelet therapy after PCI for ACS was associated with lower risk for adverse events at 30 months vs. shorter duration DAPT, a speaker reported.

Nearly one-third of patients with atrial fibrillation and/or venous thromboembolism treated with a direct oral anticoagulant, or DOAC, were also using aspirin without clear indications, researchers reported.

The odds of readmission for acute MI or major bleeding after PCI were greater among patients with cancer compared with those with no cancer, with the likelihood varying by cancer type and presence of metastasis, researchers reported.