PMID- 27467697
OWN - NLM
STAT- MEDLINE
DCOM- 20170802
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 7
DP  - 2016
TI  - Dual Antiplatelet Therapy (DAPT) versus No Antiplatelet Therapy and Incidence of 
      Major Bleeding in Patients on Venoarterial Extracorporeal Membrane Oxygenation.
PG  - e0159973
LID - 10.1371/journal.pone.0159973 [doi]
LID - e0159973
AB  - AIMS: Bleeding is a frequent complication in patients on venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO). An indication for dual 
      antiplatelet therapy due to coronary stent implantation is present in a 
      considerable number of these patients. The objective of this retrospective study 
      was to evaluate if dual antiplatelet therapy (DAPT) significantly increases the 
      high intrinsic bleeding risk in patients on VA-ECMO. METHODS AND RESULTS: A total 
      of 93 patients were treated with VA-ECMO between October 2010 and October 2013. 
      Average time on VA-ECMO was 58.9 +/- 1.7 hours. Dual antiplatelet therapy was given 
      to 51.6% of all patients. Any bleeding was recorded in 60.2% of all patients. 
      There was no difference in bleeding incidence in patients on DAPT when compared 
      to those without any antiplatelet therapy including any bleeding (66.7% vs. 
      57.1%, p = 0.35), BARC3 bleeding (43.8% vs. 33.3%, p = 0.31) or pulmonary 
      bleeding (16.7% vs. 19.0%, p = 0.77). This holds true after adjustment for 
      confounders. Rate of transfusion of red blood cells were similar in patients with 
      or without DAPT (35.4% vs. 28.6%, p = 0.488). CONCLUSIONS: Bleeding on VA-ECMO is 
      frequent. This registry recorded no statistical difference in bleeding in 
      patients on dual antiplatelet therapy when compared to no antiplatelet therapy. 
      When indicated, DAPT should not be withheld from VA ECMO patients.
FAU - Staudacher, Dawid L
AU  - Staudacher DL
AUID- ORCID: 0000-0002-9423-9682
AD  - Heart Center Freiburg University, Department of Cardiology and Angiology I, 
      Freiburg, Germany.
FAU - Biever, Paul M
AU  - Biever PM
AD  - Heart Center Freiburg University, Department of Cardiology and Angiology I, 
      Freiburg, Germany.
FAU - Benk, Christoph
AU  - Benk C
AD  - Heart Center Freiburg University, Department of Cardiovascular Surgery, Freiburg, 
      Germany.
FAU - Ahrens, Ingo
AU  - Ahrens I
AD  - Heart Center Freiburg University, Department of Cardiology and Angiology I, 
      Freiburg, Germany.
FAU - Bode, Christoph
AU  - Bode C
AD  - Heart Center Freiburg University, Department of Cardiology and Angiology I, 
      Freiburg, Germany.
FAU - Wengenmayer, Tobias
AU  - Wengenmayer T
AD  - Heart Center Freiburg University, Department of Cardiology and Angiology I, 
      Freiburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20160728
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Blood Component Transfusion
MH  - Case-Control Studies
MH  - Drug Therapy, Combination
MH  - Extracorporeal Membrane Oxygenation/*adverse effects
MH  - Female
MH  - Hemorrhage/*etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*administration & dosage
PMC - PMC4965019
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2016/07/29 06:00
MHDA- 2017/08/03 06:00
PMCR- 2016/07/28
CRDT- 2016/07/29 06:00
PHST- 2016/05/31 00:00 [received]
PHST- 2016/07/11 00:00 [accepted]
PHST- 2016/07/29 06:00 [entrez]
PHST- 2016/07/29 06:00 [pubmed]
PHST- 2017/08/03 06:00 [medline]
PHST- 2016/07/28 00:00 [pmc-release]
AID - PONE-D-16-21878 [pii]
AID - 10.1371/journal.pone.0159973 [doi]
PST - epublish
SO  - PLoS One. 2016 Jul 28;11(7):e0159973. doi: 10.1371/journal.pone.0159973. 
      eCollection 2016.