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Bleeding after dual antiplatelet therapy

12 February 2016

University of Bristol researchers have been awarded £432,000 by the National Institute for Health Research to study the effect of antiplatelet drugs on bleeding risk

Antiplatelet drugs, such as aspirin, clopidogrel (Plavix), prasugrel (Effient) and ticagrelor (Brilinta), are used to prevent heart disease and stroke. They work by preventing the formation of blood clots in arteries. Antiplatelet drugs are given to all people who have diseased arteries, have had a heart attack, had a coronary stent put in or had heart surgery. A combination of aspirin and another antiplatelet drug is normally given – this is called dual antiplatelet therapy (DAPT).
Antiplatelet therapies increase the risk of bleeding. About 1 in 100 people on aspirin and 2 in 100 people on DAPT have a major bleeding event that needs admission to hospital. However, many more people experience minor bleeding, such as bleeding in the stomach or bowel, and nuisance bleeding, such as nosebleeds, bleeding from gums, and excessive bruising. These minor bleeding events cause discomfort and anxiety, take up consultations with GPs and may cause patients to stop taking their tablets as prescribed.

The researchers, led by Dr Maria Pufulete, Research Fellow in Health Services Research in the School of Clinical Sciences, will use a large GP database of routinely collected data and a database of describing patients’ attendances and admissions to hospital to determine how many people experience bleeding after being prescribed different DAPT regimens. Information from the study will help hospital doctors to choose drugs that are more appropriate for individual patients’ specific needs, which will reduce the risk of bleeding and increase adherence to treatment.

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