PMID- 37437516
OWN - NLM
STAT- MEDLINE
DCOM- 20230904
LR  - 20230926
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 229
DP  - 2023 Sep
TI  - Antiplatelet and anticoagulant therapies in hereditary hemorrhagic 
      telangiectasia: A large French cohort study (RETROPLACOTEL).
PG  - 107-113
LID - S0049-3848(23)00213-X [pii]
LID - 10.1016/j.thromres.2023.07.001 [doi]
AB  - BACKGROUND: It is unclear whether hereditary hemorrhagic telangiectasia (HHT) 
      patients can tolerate antithrombotic therapies (AT) including antiplatelet (AP) 
      and/or anticoagulant (AC) agents. OBJECTIVES: Primary endpoint was tolerance to 
      AT in HHT. Secondary endpoints were to identify factors associated with major 
      bleeding events (MBE) and premature discontinuation of AT. METHODS: Retrospective 
      multicenter study in French national HHT Registry patients exposed to AT. 
      RESULTS: We included 126 patients with 180 courses of AT. Median follow-up was 24 
      [11-52] months. Mean age was 65.6 +/- 13.1 years. The first 3 months of AT exposure 
      had an increased risk of hospitalization for hemorrhage (p < 0.001) and 
      transfusions (p < 0.001). MBE (n = 63) occurred more frequently in the first 
      3 months of AT exposure (p < 0.001). Premature discontinuation of AT occurred in 
      61 cases. Rate of premature discontinuation was 29 % under both AP and AT therapy 
      but significantly higher under dual AP therapy (n = 4/7, 57 % p = 0.008). Risk 
      factors for MBE were: age >/= 60 years (HR 2.34 [1.12;4.87], p = 0.023), prior 
      hospitalization in the 3 months before starting AT for hemorrhage (HR 3.59 
      [1.93;6.66], p < 0.001) or transfusion (HR 3.15 [1.61;6.18], p = 0.001), previous 
      history of gastro-intestinal bleeding (HR 2.71 [1.57;4.65], p < 0.001) or MBE (HR 
      4.62 [2.68;7.98], p < 0.001). Frequency of MBE did not differ between groups 
      except for a higher risk in the dual AP group (HR 3.92 [1.37;11.22], p = 0.011). 
      CONCLUSION: Tolerance of AC or AP therapy was similar in HHT population but not 
      dual AP therapy. We identified risk factors for MBE occurrence or premature 
      discontinuation under AT.
CI  - Copyright (c) 2023 Elsevier Ltd. All rights reserved.
FAU - Grobost, Vincent
AU  - Grobost V
AD  - Service de Medecine Interne, Clermont-Ferrand University Hospital, CHU Estaing, 
      63000 Clermont-Ferrand, France. Electronic address: 
      vgrobost@chu-clermontferrand.fr.
FAU - Hammi, Sami
AU  - Hammi S
AD  - Department of Internal Medicine, Angers University Hospital, 49100 Angers, 
      France.
FAU - Pereira, Bruno
AU  - Pereira B
AD  - Biostatistics Unit, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, 
      France.
FAU - Guilhem, Alexandre
AU  - Guilhem A
AD  - Hospices Civils de Lyon, Hopital Femme-Mere-Enfants, Service de Genetique et 
      centre de reference de la maladie de Rendu-Osler, 69677 Bron, France.
FAU - Duffau, Pierre
AU  - Duffau P
AD  - Bordeaux University Hospital, Internal Medicine and Clinical Immunology 
      Department, Universite de Bordeaux, CNRS ImmunoConcEpT UMR 5164, 33000 Bordeaux, 
      France.
FAU - Seguier, Julie
AU  - Seguier J
AD  - Departement de Medecine Interne, Marseille University Hospital, 13000 Marseille, 
      France.
FAU - Parrot, Antoine
AU  - Parrot A
AD  - Assistance Publique-Hopitaux de Paris, Service de Pneumologie et Centre de 
      Competence de la Maladie de Rendu Osler, Hopital Tenon, 75020 Paris, France.
FAU - Gautier, Giovanni
AU  - Gautier G
AD  - Nantes Universite, Nantes University Hospital, Department of Internal and 
      Vascular Medicine, 44000 Nantes, France.
FAU - Alric, Laurent
AU  - Alric L
AD  - Internal Medicine-Digestive Medicine, CHU Rangueil Toulouse 3 University, 31000 
      Toulouse, France.
FAU - Kerjouan, Mallorie
AU  - Kerjouan M
AD  - Service de Pneumologie, Hopital Pontchaillou, CHU Rennes, 35000 Rennes, France.
FAU - Le Guillou, Xavier
AU  - Le Guillou X
AD  - Medical Genetics Department, University Hospital of Poitiers, 86000 Poitiers, 
      France.
FAU - Simon, Delphine
AU  - Simon D
AD  - Service de Medecine Interne, CHU Charles Nicolle, 76000 Rouen, France.
FAU - Chaussavoine, Laurent
AU  - Chaussavoine L
AD  - Centre Hospitalier Universitaire de Caen Normandie, Service de Medecine 
      Vasculaire, 14000 Caen, France.
FAU - Rondeau-Lutz, Murielle
AU  - Rondeau-Lutz M
AD  - Service de Medecine Interne, Nouvel Hopital Civil, Hopitaux Universitaires de 
      Strasbourg, 67 091 Strasbourg cedex, France.
FAU - Leguy-Seguin, Vanessa
AU  - Leguy-Seguin V
AD  - Department of Internal Medicine, CHU Francois Mitterrand, 21000 Dijon, France.
FAU - Delagrange, Laura
AU  - Delagrange L
AD  - Hospices Civils de Lyon, Hopital Femme-Mere-Enfants, Service de Genetique et 
      centre de reference de la maladie de Rendu-Osler, 69677 Bron, France.
FAU - Lavigne, Christian
AU  - Lavigne C
AD  - Department of Internal Medicine, Angers University Hospital, 49100 Angers, 
      France.
FAU - Maillard, Helene
AU  - Maillard H
AD  - Department of Internal Medicine and Clinical Immunology, Referral Centre for rare 
      systemic autoimmune diseases for North and North-West France (CeRAINO), CHU 
      Lille, 59000, Lille, France.
FAU - Dupuis-Girod, Sophie
AU  - Dupuis-Girod S
AD  - Hospices Civils de Lyon, Hopital Femme-Mere-Enfants, Service de Genetique et 
      centre de reference de la maladie de Rendu-Osler, 69677 Bron, France.
CN  - French HHT group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230706
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Cohort Studies
MH  - *Telangiectasia, Hereditary Hemorrhagic/complications/drug therapy
MH  - Anticoagulants/therapeutic use
MH  - Gastrointestinal Hemorrhage/chemically induced
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Anticoagulant
OT  - Antiplatelet
OT  - Direct oral anticoagulant
OT  - Hereditary hemorrhagic telangiectasia
OT  - Major bleeding event
COIS- Declaration of competing interest The authors declare the following financial 
      interests/personal relationships which may be considered as potential competing 
      interests: Only one author have potential conflict of interest: L. Chaussavoine 
      with ASPEN, Leo Pharma, Bayer Healthcare.
EDAT- 2023/07/13 01:06
MHDA- 2023/09/04 06:43
CRDT- 2023/07/12 18:09
PHST- 2023/04/12 00:00 [received]
PHST- 2023/06/02 00:00 [revised]
PHST- 2023/07/05 00:00 [accepted]
PHST- 2023/09/04 06:43 [medline]
PHST- 2023/07/13 01:06 [pubmed]
PHST- 2023/07/12 18:09 [entrez]
AID - S0049-3848(23)00213-X [pii]
AID - 10.1016/j.thromres.2023.07.001 [doi]
PST - ppublish
SO  - Thromb Res. 2023 Sep;229:107-113. doi: 10.1016/j.thromres.2023.07.001. Epub 2023 
      Jul 6.