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Background: The use of antiplatelets (ATP) or anticoagulation (AC) in asymptomatic septic patients with elevated troponin (e-Tn) is not clear. We hypothesized that use of ATP and/or AC does not improve outcomes in septic patients with e-Tn during or after hospitalization.
Methods: We examined 936 septic patients (mean age66±17years, 54% females) with e-Tn. Those with septic shock and death during hospitalization were excluded. Outcomes included any major bleeding (MB) and mortality. We examined the association of ATP and AC use with these outcomes in multivariable adjusted Cox regression models.
Results: Over a median follow up of 5 years, 37 (4.0%) had MB episodes and 361 (38.5%) deaths occurred. 221 (23.6%) patients that received ATP and AC during hospitalization. On discharge, 160 (17.1%) were on ATP and 149 (15.9%) were on AC. In multivariable Cox regression model, use of ATP and/or AC during hospitalization was not associated with lower risk of mortality (HR 0.88; 95% CI 0.68, 1.13, p = 0.31) or MB (HR 1.34; 95% CI 0.68, 2.64). At discharge, use of ATP and AC was associated with reduced risk of mortality (HR 0.75; 95% CI 0.58, 0.95, p = 0.01) without significant association with MB (HR 1.40; 95% CI 0.70, 2.78) (Figure 1).
Conclusions: We observed better survival without increase in risk of MB among septic patients with e-Tn who were discharged on ATP and/or AC. However, we did not find similar impact when administered during hospitalization. Future studies should focus on improving outcomes in this group of patients.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Considerations in Antiplatelet Therapy and in ACS
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1113-145
- 2017 American College of Cardiology Foundation