Effects of thienopyridine class antiplatelets on bleeding outcomes following robot-assisted radical prostatectomy.

Autor: Kubota M; Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.; Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan., Kawakita M; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan., Yoshida S; Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan., Kimura H; Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Sumiyoshi T; Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Yamasaki T; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan., Okumura K; Department of Urology, Tenri Yorozu Hospital, Nara, Japan., Yoshimura K; Department of Urology, Shizuoka General Hospital, Shizuoka, Japan., Matsui Y; Department of Urology, National Cancer Center Hospital, Tokyo, Japan., Sugiyama K; Department of Urology, Kurashiki Central Hospital, Okayama, Japan., Okuno H; Department of Urology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan., Segawa T; Department of Urology, Kyoto City Hospital, Kyoto, Japan., Shimizu Y; Department of Urology, Kobe City Nishi-Kobe Medical Center, Kobe, Hyogo, Japan., Ito N; Department of Urology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan., Onishi H; Department of Urology, Japanese Red Cross Osaka Hospital, Osaka, Japan., Ishitoya S; Department of Urology, Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan., Soda T; Department of Urology, Kitano Hospital, Osaka, Japan., Yoshida T; Department of Urology, Shiga General Hospital, Moriyama, Shiga, Japan., Uemura Y; Department of Urology, Toyooka Hospital, Toyooka, Hyogo, Japan., Iwamura H; Department of Urology, Himeji Medical Center, Himeji, Hyogo, Japan., Okubo K; Department of Urology, Kyoto Katsura Hospital, Kyoto, Japan., Suzuki R; Department of Urology, Numazu City Hospital, Shizuoka, Japan., Fukuzawa S; Department of Urology, Shimada General Medical Center, Shizuoka, Japan., Akao T; Department of Urology, Rakuwakai Otowa Hospital, Kyoto, Japan., Kurahashi R; Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan., Shimatani K; Department of Urology, Hyogo Medical University, Nishinomiya, Hyogo, Japan., Sekine Y; Department of Urology, Akita University Graduate School of Medicine, Akita, Japan., Negoro H; Department of Urology, University of Tsukuba, Tsukuba, Ibaraki, Japan., Akamatsu S; Department of Urology, Nagoya University, Nagoya, Aichi, Japan., Kamoto T; Department of Urology, Miyazaki University, Miyazaki, Japan., Ogawa O; Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Department of Urology, Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan., Kawakami K; Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan., Kobayashi T; Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan. selecao@kuhp.kyoto-u.ac.jp., Goto T; Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Mar 11; Vol. 14 (1), pp. 5847. Date of Electronic Publication: 2024 Mar 11.
DOI: 10.1038/s41598-024-56570-9
Abstrakt: This study aimed to assess the effects of thienopyridine-class antiplatelet agents (including ticlopidine, clopidogrel, and prasugrel) on bleeding complications in patients who underwent robot-assisted radical prostatectomy. This cohort study used a database for robot-assisted radical prostatectomy at 23 tertiary centers nationwide between 2011 and 2022. Patients who received thienopyridines (thienopyridine group) were compared with those who received aspirin monotherapy (aspirin group). The primary outcome was the incidence of bleeding complications. High-grade complications were defined as Clavien-Dindo grade III or higher. The risks of these outcomes were evaluated using inverse probability of treatment weighted regression models. The study results demonstrated that thienopyridine therapy was associated with a higher risk of overall bleeding complications (OR: 3.62, 95%CI 1.54-8.49). The increased risks of the thienopyridine group were detected for low-grade bleeding complications (OR: 3.20, 95%CI 1.23-8.30) but not for high-grade bleeding complications (OR: 5.23, 95%CI 0.78-34.9). The increased risk of bleeding complications was not observed when thienopyridine was discontinued (OR: 2.52, 95%CI 0.83-7.70); however, it became apparent when it was continued perioperatively (OR: 4.35, 95%CI 1.14-16.61). In conclusion, thienopyridine increased the incidence of bleeding complications, particularly low-grade bleeding complications, following robot-assisted radical prostatectomy. These bleeding effects emerged when thienopyridine was continued perioperatively.
(© 2024. The Author(s).)
Databáze: MEDLINE
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