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Volume 84, Issue 3, Pages (September 2013)

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Presentation on theme: "Volume 84, Issue 3, Pages (September 2013)"— Presentation transcript:

1 Volume 84, Issue 3, Pages 600-608 (September 2013)
Major bleeding events and risk stratification of antithrombotic agents in hemodialysis: results from the DOPPS  Manish M. Sood, Maria Larkina, Jyothi R. Thumma, Francesca Tentori, Brenda W. Gillespie, Shunichi Fukuhara, David C. Mendelssohn, Kevin Chan, Patricia de Sequera, Paul Komenda, Claudio Rigatto, Bruce M. Robinson  Kidney International  Volume 84, Issue 3, Pages (September 2013) DOI: /ki Copyright © 2013 International Society of Nephrology Terms and Conditions

2 Figure 1 Use of antithrombotic agents, by Dialysis Outcomes and Practice Patterns Study (DOPPS) phase and country. Anti-platelet agent (APA), other than aspirin (clopidogrel, ticlopidine, dipyridamole, pentoxifylline); anticoagulant (OAC) includes warfarin (85% of total OACs) and a few other products (e.g., fluindione in France (FR)); DOPPS study period: phases I–II (1998–2004) and III–IV (2005–10) with N=48,144 patients. ANZ, Australia/New Zealand; BE, Belgium; CA, Canada; GE, Germany; IT, Italy; JP, Japan; SP, Spain; SW, Sweden; UK, United Kingdom; US, United States. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

3 Figure 2 Variation in facility use of antithrombotic agents, by geographic region. N=20,475 patients from Dialysis Outcomes and Practice Patterns Study phases III and IV (2005–2010) in facilities with at least seven patients with medication use records. APA, anti-platelet agent; ANZ, Australia/New Zealand; ASA, acetylsalicylic acid; CA, Canada; EUR, Europe; JP, Japan; OAC, anticoagulant; US, United States. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

4 Figure 3 Rates of bleeding events and stroke by country. N=39,440 patients from Dialysis Outcomes and Practice Patterns Study phases I, II, and III. *Other bleeding events include epistaxis, subdural hematoma, evacuation of hematoma, hemoptysis, and hematuria. **Stroke includes hospitalization or death due to stroke. ANZ, Australia/New Zealand; BE, Belgium; CA, Canada; FR, France; GE, Germany; GI, gastrointestinal; IT, Italy; JP, Japan; SP, Spain; SW, Sweden; UK, United Kingdom; US, United States; VA, vascular access. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

5 Figure 4 Stroke rate and bleeding rate by CHADS2 score and history of gastrointestinal (GI) bleeding. Stroke risk categories are based on CHADS2 categories used commonly in the non-dialysis population: 0=low, 1=moderate, ≥2=high. n=37,657 (n=4026 atrial fibrillation) patients from Dialysis Outcomes and Practice Patterns Study phases I, II, and III. Note: patient medication usage was classified hierarchically (anticoagulant (OAC) >anti-platelet agent (APA) >acetylsalicylic acid (ASA) for patients taking ≥one medication class. See text for details). Stroke and bleeding events limited to those with atrial fibrillation are presented in a and b, whereas stroke and bleeding in the entire study cohort are presented in c and d. *Indicates too few events in category. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions


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