☆ 4.5 Article

Does Antiplatelet Therapy Increase the Risk of Hemoptysis During Percutaneous Transthoracic Needle Biopsy of a Pulmonary Lesion?

AMERICAN JOURNAL OF ROENTGENOLOGY (2013)

Journal

AMERICAN JOURNAL OF ROENTGENOLOGY

Volume 200, Issue 5, Pages 1014-1019

Publisher

AMER ROENTGEN RAY SOC

DOI: 10.2214/AJR.12.8931

Keywords

aspirin; antiplatelet; bleeding; biopsy; hemoptysis; PTNB

Funding

Korean Foundation for Cancer Research [CB-2011-02-01]
Basic Science Research Program through the National Research Foundation of Korea
Ministry of Education, Science, and Technology [2011-0022379]
National Research Foundation of Korea [2011-0022379] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)

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Abstract

OBJECTIVE. The purpose of this article is to evaluate whether antiplatelet therapy increases the occurrence and severity of percutaneous transthoracic needle biopsy (PTNB)-related hemoptysis. MATERIALS AND METHODS. Our institutional review board approved this retrospective study, with waiver of informed consent. From May 2007 to December 2009, 1251 patients undergoing 1346 PTNBs constituted our study population. Of these PTNBs, 163 were performed in patients who had suspended antiplatelet therapy for less than 10 days (mean discontinuation time, 2.56 +/- 2.35 days), and these patients were classified as antiplatelet agent users: 143 patients with single aspirin (mean discontinuation time, 2.55 +/- 2.35 days), 12 patients with single clopidogrel (mean discontinuation time, 2.33 +/- 2.10 days), and eight patients with dual-antiplatelet therapy (i.e., aspirin plus clopidogrel; mean discontinuation time, 3.12 +/- 2.90 days). The influence of antiplatelet therapy on the occurrence and severity of PTNB-related hemoptysis was retrospectively evaluated. RESULTS. Among 1346 PTNBs, there were 128 cases (9.5%) of hemoptysis, including 21 cases of severe hemoptysis (1.6%). Multivariate analysis revealed that dual-antiplatelet therapy (odds ratio [ OR], 10.09), female sex (OR, 1.88), smaller lesions (OR, 0.88), deeply located lesions (OR, 1.17), and the use of cutting needles (OR, 3.22) were independent risk factors for overall hemoptysis. For severe hemoptysis, dual-antiplatelet therapy (OR, 13.02), ground-glass nodules (OR, 8.86), and deeply located lesions (OR, 1.24) were proven to be independent risk factors. Single-antiplatelet therapy suspended for less than 10 days was not a significant risk factor for either overall or severe hemoptysis. CONCLUSION. Single-antiplatelet therapy suspended for less than 10 days is not an independent risk factor for the occurrence of PTNB-related hemoptysis, whereas dual-antiplatelet therapy increases its risk.

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Bleeding and Ischemic Risks of Ticagrelor Monotherapy After Coronary Interventions

Guiomar Mendieta, Shamir Mehta, Usman Baber, Dominick J. Angiolillo, Carlo Briguori, David Cohen, Timothy Collier, George Dangas, Dariusz Dudek, Javier Escaned, Robert Gil, Birgit Vogel, Davide Cao, Alessandro Spirito, Kurt Huber, Adnan Kastrati, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Vijay Kunadian, David J. Moliterno, E. Magnus Ohman, Gennaro Sardella, Samantha Sartori, Samin Sharma, Richard Shlofmitz, P. Gabriel Steg, Ya-Ling Han, Stuart Pocock, C. Michael Gibson, Roxana Mehran

Summary: In high-risk patients, ticagrelor monotherapy reduces bleeding events without increasing the risk of ischemic events compared to dual antiplatelet therapy. The benefit of ticagrelor monotherapy is consistent across different bleeding and ischemic risk levels.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2023)