AI Article Synopsis
- Von Willebrand disease (VWD) is a common inherited bleeding disorder, and its patients face challenges when treated for acute myocardial infarction (AMI) due to increased bleeding risks from antithrombotic therapies.
- A study analyzed outcomes of VWD patients after AMI, comparing them with non-VWD patients, focusing on readmission rates within 90 days for different causes.
- Results showed that while VWD patients had a significantly higher risk of readmission due to bleeding (4.75 times greater), there were no major differences in all-cause or arterial thrombosis-related readmissions compared to controls, highlighting the need for further research on managing these patients' risks.
Article Abstract
Background: Von Willebrand disease (VWD) is the most common inherited bleeding disorder. As treatments have improved prognosis of VWD, age-related diseases, including acute myocardial infarction (AMI), have become more prevalent. The treatment of AMI includes antithrombotic therapies, which increase the risk of bleeding. Current guidelines suggest weighing risks/benefits of antithrombotic therapy in patients with VWD. However, data to inform these discussions are lacking.
Objective: To characterize outcomes of patients with VWD after AMI.
Methods: We conducted a retrospective cohort study utilizing the National Readmissions Database of patients with and without VWD admitted with AMI in 2017 and 2018. Primary outcomes were 90-day any-cause, bleeding-related, and arterial thrombosis-related readmissions. Case-control matching was performed for age, sex (male or female), ST-elevation myocardial infarction, percutaneous coronary intervention, diabetes, and chronic kidney disease. Time-to-event analysis was performed after matching using Cox proportional hazards regression.
Results: A total of 136 patients with VWD were matched with 3400 controls without VWD. At 90 days, there were no differences in all-cause (10.7% vs 11.5%; = 1.00), arterial thrombosis (1.9% vs 3.1%; = .77), and bleeding (1.9% vs 0.4%; = .083) readmission in patients with VWD. VWD was associated with increased risk of 90-day bleeding (hazard ratio [HR], 4.75; 95% CI, 1.05-21.66) but not all-cause (HR, 0.91; 95% CI, 0.50-1.67) or arterial thrombosis (HR, 0.54; 95% CI, 0.39-2.19) readmission.
Conclusion: Among patients admitted with AMI, VWD was associated with higher risk of 90-day readmission for bleeding but not any-cause and arterial thrombosis-related readmissions. Further studies are needed to balance bleeding and thrombotic risks post-AMI in patients with VWD.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10558305 | PMC |
| http://dx.doi.org/10.1016/j.rpth.2023.102198 | DOI Listing |
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