10:36pm Tuesday 15 October 2019

Anti-platelet drug with fewer surgery-related bleeding complications


This appears from a study at The Sahlgrenska Academy which will be presented on September 1, at the world’s largest cardiology conference.

In order to avoid blood clots, most heart patients are prescribed blood-thinning medications. One such is platelet inhibitors , which reduces the ability of platelets to aggregate.

One complication of anti-platelets is that they also increase the risk of serious bleeding in conjunction with heart operations. Researchers at The Sahlgrenska Academy have now, in a national study, investigated 2,244 patients who were bypass-operated due to coronary artery disease over a two-year period.

Correlates to complications

The purpose was to investigate whether there is a correlation between serious bleeding complications and which anti-platelet medications the patients had taken.

The study shows that patients who received the drug Plavix were affected by serious bleeding complications to a greater extent than patients who received the newer drug Brilique, which has recently been developed by AstraZeneca in Mölndal.

Reduced risk

The share of patients who were affected by bleeding complications was 17.6 percent for Plavix and 12.9 percent with Brilique. After correcting for other factors which affect the bleeding risk, there were 28 percent fewer bleeding complications in the Brilique group.

In order to diminish the risk of bleeding, treatment with antiplatelets should, if possible, be discontinued five days before the operation. The Gothenburg study now shows that patients who are treated with Brilique can discontinue treatment three days before the operation, without thereby increasing the risk of bleeding complications.

– For the patient, the risk of suffering new heart problems while waiting for the operation is thus reduced. This also saves hospital resources, since the patients wait for the antiplatelet effect to cease in a hospital. Given that a day’s care in a cardiac intensive care unit is very expensive, this can result in large savings for health care, said Anders Jeppsson, consultant in cardiothoracic surgery and researcher at The Sahlgrenska Academy, Gothenburg University, and the primary investigator of the study.

International interest

In Sweden most patients already receive Brilique, but seen globally Plavix is the most commonly used antiplatelet drug of this type.

The international interest in the Gothenburg study is therefore substantial: when the article ”Coronary artery bypass grafting-related bleeding complications in patients treated with ticagrelor or clopidogrel: a nationwide study” is published in the European Heart Journal on 1 September it will be presented at the same time at a special symposium at the European Society of Cardiology’s congress in London. ESC is the world’s largest cardiology conference, with about 30,000 participants.

Link to journal

Image above: Anders Jeppsson conducting hear surgery.

Anders Jeppsson, Professor at The Sahlgrenska Academy, Gothenburg University, and supervising physician at The Sahlgrenska University Hospital


BY: Krister Svahn
031 786 38 69

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