Aspirin use is safe in patients undergoing transbronchial lung cryobiopsy.
Aspirin
Clopidogrel
Cryobiopsy
Guidelines
Practice management
Journal
Heliyon
ISSN: 2405-8440
Titre abrégé: Heliyon
Pays: England
ID NLM: 101672560
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
25
06
2023
revised:
02
11
2023
accepted:
02
11
2023
medline:
11
12
2023
pubmed:
11
12
2023
entrez:
11
12
2023
Statut:
epublish
Résumé
Aspirin has been shown to be safe for patients undergoing certain diagnostic bronchoscopy procedures, such as transbronchial biopsies and endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration. However, there are no studies documenting the safety of aspirin in patients undergoing To determine whether aspirin increases the risk of bleeding during or following TBLC. 172 consecutive patients undergoing TBLC were included in this retrospective cohort study. Data on demographic characteristics, comorbidities etc. were collected. Bleeding severity was defined by the intervention needed to stop the bleeding: mild-cold saline injection, moderate-adrenalin/hexakarpon injection, or severe - Intensive Care Unit admission after bronchoscopy. Fifty-one patients (29.6 %) were under aspirin treatment at the time of TBLC. Overall, there was no significant difference between the aspirin and the control groups regarding the incidence of moderate-severe bleeding (41.2 % vs. 33.1 %, respectively, p.0.31). the Clopidogrel was found as a risk factor for increased bleeding when taken together with aspirin (Odds ratio = 9.8 (1.1-86), p = 0.013). When taken alone, clopidogrel was also found as a risk factor to increased bleeding, yet these results didn't reach significance due to low number of patients (fig. 1, N = 5, Odds ratio = 2.8 (0.46-17.35), p = 0.245). No difference was observed between the groups regarding additional post-procedural complications, including pneumothorax, hospitalizations, and mortality. To the best of our knowledge, this is the first study examining bleeding risk of cryobiopsy under aspirin treatment. Based on our results, it seems safe to perform TBLC under aspirin treatment, except for patients who are concurrently treated with clopidogrel. Further research should be conducted to substantiate this conclusion.
Sections du résumé
Background
UNASSIGNED
Aspirin has been shown to be safe for patients undergoing certain diagnostic bronchoscopy procedures, such as transbronchial biopsies and endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration. However, there are no studies documenting the safety of aspirin in patients undergoing
Objective
UNASSIGNED
To determine whether aspirin increases the risk of bleeding during or following TBLC.
Methods
UNASSIGNED
172 consecutive patients undergoing TBLC were included in this retrospective cohort study. Data on demographic characteristics, comorbidities etc. were collected. Bleeding severity was defined by the intervention needed to stop the bleeding: mild-cold saline injection, moderate-adrenalin/hexakarpon injection, or severe - Intensive Care Unit admission after bronchoscopy.
Results
UNASSIGNED
Fifty-one patients (29.6 %) were under aspirin treatment at the time of TBLC. Overall, there was no significant difference between the aspirin and the control groups regarding the incidence of moderate-severe bleeding (41.2 % vs. 33.1 %, respectively, p.0.31). the Clopidogrel was found as a risk factor for increased bleeding when taken together with aspirin (Odds ratio = 9.8 (1.1-86), p = 0.013). When taken alone, clopidogrel was also found as a risk factor to increased bleeding, yet these results didn't reach significance due to low number of patients (fig. 1, N = 5, Odds ratio = 2.8 (0.46-17.35), p = 0.245). No difference was observed between the groups regarding additional post-procedural complications, including pneumothorax, hospitalizations, and mortality.
Conclusion
UNASSIGNED
To the best of our knowledge, this is the first study examining bleeding risk of cryobiopsy under aspirin treatment. Based on our results, it seems safe to perform TBLC under aspirin treatment, except for patients who are concurrently treated with clopidogrel. Further research should be conducted to substantiate this conclusion.
Identifiants
pubmed: 38076036
doi: 10.1016/j.heliyon.2023.e22047
pii: S2405-8440(23)09255-1
pmc: PMC10709165
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e22047Informations de copyright
© 2023 Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
N Engl J Med. 2018 Oct 18;379(16):1509-1518
pubmed: 30221597
Chest. 2012 Feb;141(2 Suppl):e89S-e119S
pubmed: 22315278
Chest. 2017 Feb;151(2):400-408
pubmed: 27660154
PLoS One. 2014 Feb 28;9(2):e86716
pubmed: 24586252
Chest. 2013 Mar;143(3):621-626
pubmed: 23328889
BMJ. 2011 Aug 04;343:d4588
pubmed: 21816733
Lung. 2022 Apr;200(2):153-159
pubmed: 35103841
Lancet. 2020 Mar 7;395(10226):785-794
pubmed: 31492501
Chest. 2021 Dec;160(6):2247-2259
pubmed: 34352279
PLoS One. 2020 Aug 7;15(8):e0237022
pubmed: 32764775
Respiration. 2016;91(3):215-27
pubmed: 26926876
Am J Respir Crit Care Med. 2016 Apr 1;193(7):745-52
pubmed: 26562389
J Thorac Dis. 2017 Jul;9(7):2186-2203
pubmed: 28840020
Arch Bronconeumol. 2010 Mar;46(3):111-5
pubmed: 19939546
JAMA. 2019 Jan 22;321(3):277-287
pubmed: 30667501
Respir Care. 2016 May;61(5):700-12
pubmed: 26932382
AJNR Am J Neuroradiol. 2013 Apr;34(4):721-6
pubmed: 23275598
Respiration. 2018;95(6):383-391
pubmed: 29894993
Circulation. 2011 Nov 29;124(22):2458-73
pubmed: 22052934
JAMA. 2022 Apr 26;327(16):1577-1584
pubmed: 35471505
Eur Respir Rev. 2017 Jul 19;26(145):
pubmed: 28724561
Am J Cardiovasc Drugs. 2022 Nov;22(6):657-675
pubmed: 35570250
J Thorac Dis. 2017 Sep;9(Suppl 10):S1022-S1033
pubmed: 29214062
Clin Transl Sci. 2021 Mar;14(2):645-655
pubmed: 33202084
Arch Intern Med. 2010 Sep 13;170(16):1433-41
pubmed: 20837828
Respir Res. 2019 Jul 5;20(1):140
pubmed: 31277659
Am J Hematol. 2004 Jan;75(1):40-7
pubmed: 14695631
Eur Heart J. 2013 Oct;34(38):2949-3003
pubmed: 23996286
Chest. 2021 Nov;160(5):1890-1901
pubmed: 34022184
Ther Adv Respir Dis. 2016 Aug;10(4):318-23
pubmed: 27165086
Chest. 2002 Oct;122(4):1461-4
pubmed: 12377879
N Engl J Med. 2021 May 27;384(21):1981-1990
pubmed: 33999548
Respiration. 2012;83(4):330-4
pubmed: 22286347
Eur Respir Rev. 2022 Oct 5;31(166):
pubmed: 36198419
Respiration. 2019;98(5):421-427
pubmed: 31554006
Chest. 2006 Mar;129(3):734-7
pubmed: 16537875