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Master Thesis

Comparaison du risque hémorragique sous ticagrelor et du clopidogrel en réanimation chez des patients présentant un syndrome coronarien aigu admis en réanimation

Abstract : Background: Intensive care unit (ICU) patients with the most severe forms of acute coronary syndrome (ACS) require invasive therapies. The risk of bleeding in ICU patients with ACS treated with a dual antiplatelet therapy of aspirin and ticagrelor is unknown. The primary objective of this study was to compare the bleeding risk of ticagrelor and clopidogrel in ICU patients with ACS. Method: We conducted a retrospective study based on a propensity score and a proportional hazards model. All patients with ACS hospitalized in the ICU of a French university hospital between January 2013 and January 2017 were included in the study. Bleeding during ICU stay was defined as all Thrombolysis in myocardial infarction (TIMI) major or minor events. Results: A total of 155 patients were included in the study. According to propensity score matching, 57 patients treated with aspirin and ticagrelor were matched with 57 patients treated with aspirin and clopidogrel. Bleeding during ICU stay occurred in 12 patients (21.1%) treated with clopidogrel and in 35 patients (61.4%) treated with ticagrelor (p<0.0001). This significant association was found for both TIMI major bleeding (12.3% vs. 35.1%, p=0.004) and TIMI minor bleeding (8.8% vs. 26.3%, p=0.01). No significant difference in ICU mortality was found between the two groups (45.6% in the clopidogrel group vs. 29.8% in the ticagrelor group, p=0.08). Conclusion: Bleeding complications are frequent and serious in ICU patients with ACS. A dual antiplatelet therapy of aspirin and ticagrelor is associated with a higher risk of bleeding compared to a dual antiplatelet therapy of aspirin and clopidogrel.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03269842
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Submitted on : Thursday, June 24, 2021 - 12:37:01 PM
Last modification on : Wednesday, June 30, 2021 - 9:40:16 PM
Long-term archiving on: : Saturday, September 25, 2021 - 6:23:32 PM

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  • HAL Id : dumas-03269842, version 1

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Thibault Charpentier. Comparaison du risque hémorragique sous ticagrelor et du clopidogrel en réanimation chez des patients présentant un syndrome coronarien aigu admis en réanimation. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03269842⟩

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