Model Predicts Bleeding in Those on Antiplatelets After TIA, Stroke

This article originally appeared here.
Share this content:
Model Predicts Bleeding in Those on Antiplatelets After TIA, Stroke
Model Predicts Bleeding in Those on Antiplatelets After TIA, Stroke

FRIDAY, Aug. 4, 2017 (HealthDay News) -- For patients with a transient ischemic attack (TIA) or ischemic stroke who use antiplatelet agents, a score with multiple predictors can be used to estimate the three-year major bleeding risk, according to research published online Aug. 2 in Neurology.

Nina A. Hilkens, M.D., from the University Medical Center Utrecht in the Netherlands, and colleagues combined individual patient data from six randomized clinical trials that examined antiplatelet therapy after TIA or ischemic stroke. The authors derived and validated a risk prediction model to examine the correlation between predictors and major bleeding, and assessed performance with the c statistic.

The researchers found that during 94,833 person-years of follow-up, major bleeding occurred in 1,530 of the 43,112 patients. The estimated risk of major bleeding over three years was 4.6 percent; predictors included male sex, smoking, type of antiplatelet agents (aspirin-clopidogrel), outcome on modified Rankin Scale ≥3, prior stroke, high blood pressure, lower body mass index, elderly, Asian ethnicity, and diabetes (S2TOP-BLEED). The c statistic of the S2TOP-BLEED score was 0.63, exhibiting good calibration in the development data. Major bleeding ranged from 2 to more than 10 percent in patients aged 45 to 54 years without additional risk factors and among patients aged 75 to 84 years with multiple risk factors, respectively. The model had a c statistic of 0.61 in external validation, and slightly underestimated the risk of major bleeding.

"The discriminatory performance may be improved by identifying stronger predictors of major bleeding," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry; several pharmaceutical companies provided access to databases.

Abstract
Full Text (subscription or payment may be required)
Editorial

Share this content:

is free, fast, and customized just for you!

Already a member?

Sign In Now »


Sign up for myCME e-newsletters


Drug Lookup

Browse drugs by: BrandGenericDisease

Trending Activities

All Professions

More in Home

NAFLD Linked to Smaller Total Cerebral Brain Volume

NAFLD Linked to Smaller Total Cerebral Brain Volume

Significant correlation even after adjustment for all covariates, including age, sex, alcohol consumption

Salivary miRNAs Can ID Duration of Concussion Symptoms

Salivary miRNAs Can ID Duration of Concussion Symptoms

Pediatric patients with prolonged symptoms were accurately identified by levels of five miRNAs

Treatment Trajectories Vary for Children With Depression

Treatment Trajectories Vary for Children With Depression

Most common class got psychotherapy monotherapy, and had lowest incidence of attempted suicide

is free, fast, and customized just for you!

Already a member?

Sign In Now »