Contraindication to antiplatelet rx for about 18 percent with PCI

(HealthDay)—About 18 percent of patients undergoing percutaneous coronary intervention (PCI) have a contraindication to commonly used antiplatelet medications, according to a study published online May 31 in Circulation: Cardiovascular Quality and Outcomes.

Geoffrey D. Barnes, M.D., from the Ann Arbor VA Medical Center in Michigan, and colleagues evaluated patients with contraindications to commonly used antiplatelet medications during and after PCI. The authors used national Veterans Affairs Clinical Assessment, Reporting, and Tracking program data for all PCIs performed between 2007 and 2013. They examined the correlation between contraindicated medications and outcomes of periprocedural bleeding and 30-day mortality.

The researchers found that 17.6 percent of the 64,294 patients undergoing PCI had a contraindication to a common antiplatelet medication, and 6.5 percent of these patients received a contraindicated medication. Any contraindicated medication use correlated with increased bleeding and 30-day mortality in unadjusted-analyses. After adjustment, significant correlations persisted for contraindicated abciximab use in patients with thrombocytopenia (hazard ratio, 2.23) and in patients with a previous stroke (hazard ratio, 1.93). In adjusted models there was no significant correlation noted for contraindicated abciximab use with 30-day mortality. In dialysis patients, eptifibatide use was not associated with an increased risk of bleeding or mortality.

"Approximately 6 percent of those patients received a contraindicated medication with attendant bleeding risk, although this did not translate into significantly higher risk of 30-day mortality," the authors write.

Two authors disclosed financial ties to the pharmaceutical, medical device, and health insurance industries.

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