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Published in: Lung 3/2016

01-06-2016

Clinical Features and Outcomes of Diffuse Alveolar Hemorrhage During Antithrombotic Therapy: A Retrospective Cohort Study

Authors: T. Otoshi, Y. Kataoka, A. Nakagawa, K. Otsuka, K. Tomii

Published in: Lung | Issue 3/2016

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Abstract

Purpose

Antithrombotic therapy could trigger diffuse alveolar hemorrhage (DAH), and there are several case reports of DAH that occurred during antithrombotic therapy (DAH-AT). However, little is known about the clinical features and outcomes of DAH-AT. The purpose of this study was to clarify the features and mortality of DAH-AT.

Methods

76 consecutive patients with DAH who were admitted to our hospital between January 2003 and April 2014 were retrospectively reviewed to identify the clinical features and outcomes of DAH-AT. The primary outcome was 90-day mortality.

Results

Of the 76 patients with DAH, 39 patients (51 %) had DAH-AT, and 37 patients (49 %) had DAH that occurred with no antithrombotic therapy (DAH-NAT). Of the patients with DAH-AT, 25 (64 %) were taking aspirin, 14 (36 %) were taking warfarin, 5 (13 %) were taking clopidogrel sulfate, and 4 (10 %) were taking cilostazol. Pre-existing cardiac disease was present in 23 (59 %) DAH-AT cases and 5 (14 %) DAH-NAT cases. Logistic regression analysis was used to assess the effect of antithrombotic therapy on the mortality of DAH patients, and no significant difference in survival was seen with antithrombotic therapy (OR 1.18, 95 % CI 0.38–3.78).

Conclusions

Antithrombotic therapies had no effect on the 90-day mortality of DAH patients.
Literature
1.
go back to reference de Prost N, Parrot A, Picard C et al (2010) Diffuse alveolar haemorrhage: factors associated with in-hospital and long-term mortality. Eur Respir J 35:1303–1311CrossRefPubMed de Prost N, Parrot A, Picard C et al (2010) Diffuse alveolar haemorrhage: factors associated with in-hospital and long-term mortality. Eur Respir J 35:1303–1311CrossRefPubMed
2.
go back to reference Antithrombotic Trialists’ Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86CrossRef Antithrombotic Trialists’ Collaboration (2002) Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86CrossRef
3.
go back to reference Erdogan D, Kocaman O, Oflaz H, Goren T (2004) Alveolar hemorrhage associated with warfarin therapy: a case report and literature review. Int J Cardiovasc Imaging 20:155–159CrossRefPubMed Erdogan D, Kocaman O, Oflaz H, Goren T (2004) Alveolar hemorrhage associated with warfarin therapy: a case report and literature review. Int J Cardiovasc Imaging 20:155–159CrossRefPubMed
4.
go back to reference Hayashi S, Maruoka S, Nakagawa Y, Takahashi N, Hashimoto S (2013) Diffuse alveolar hemorrhage associated with low molecular weight heparin. Respirol Case Rep 1:2–4PubMedPubMedCentral Hayashi S, Maruoka S, Nakagawa Y, Takahashi N, Hashimoto S (2013) Diffuse alveolar hemorrhage associated with low molecular weight heparin. Respirol Case Rep 1:2–4PubMedPubMedCentral
5.
go back to reference Boussuges A, Pinet C, Thomas P, Bergmann E, Sainty JM, Vervloet D (1999) Haemoptysis after breath-hold diving. Eur Respir J 13:697–699CrossRefPubMed Boussuges A, Pinet C, Thomas P, Bergmann E, Sainty JM, Vervloet D (1999) Haemoptysis after breath-hold diving. Eur Respir J 13:697–699CrossRefPubMed
6.
go back to reference Ikeda M, Tanaka H, Sadamatsu K (2011) Diffuse alveolar hemorrhage as a complication of dual antiplatelet therapy for acute coronary syndrome. Cardiovasc Revascularization Med 12:407–411CrossRef Ikeda M, Tanaka H, Sadamatsu K (2011) Diffuse alveolar hemorrhage as a complication of dual antiplatelet therapy for acute coronary syndrome. Cardiovasc Revascularization Med 12:407–411CrossRef
7.
go back to reference Kim Y, Lim J, Kim S, Jung T, Choi W (2013) Pulmonary alveolar hemorrhage after clopidogrel use for ST elevation myocardial infarction. Korean Circ J 43:497–499CrossRefPubMedPubMedCentral Kim Y, Lim J, Kim S, Jung T, Choi W (2013) Pulmonary alveolar hemorrhage after clopidogrel use for ST elevation myocardial infarction. Korean Circ J 43:497–499CrossRefPubMedPubMedCentral
8.
go back to reference Kalinczuk L, Lubiszewska B, Demkow M (2011) Normal chest radiograph and ground glass opacities on a thoracic computed tomographic scan in a patient with diffuse alveolar haemorrhage due to dual antiplatelet therapy prescribed after patent foramen ovale percutaneous device closure. Eur Heart J 32:2988CrossRefPubMed Kalinczuk L, Lubiszewska B, Demkow M (2011) Normal chest radiograph and ground glass opacities on a thoracic computed tomographic scan in a patient with diffuse alveolar haemorrhage due to dual antiplatelet therapy prescribed after patent foramen ovale percutaneous device closure. Eur Heart J 32:2988CrossRefPubMed
10.
go back to reference Fujimoto K, Fujishiro M, Kato M et al (2012) Guideline for the management of antithrombotic agents in the endoscopic procedures. Gastroenterol Endosc 54:2073–2102 Fujimoto K, Fujishiro M, Kato M et al (2012) Guideline for the management of antithrombotic agents in the endoscopic procedures. Gastroenterol Endosc 54:2073–2102
11.
go back to reference Hosmer DW, Lemeshow S (2000) Applied logistic regression. 2nd ed. John Wiley & Sons, New YorkCrossRef Hosmer DW, Lemeshow S (2000) Applied logistic regression. 2nd ed. John Wiley & Sons, New YorkCrossRef
12.
go back to reference Psaty BM, Koepsell TD, Lin D, Weiss NS, Siscovick DS, Rosendaal FR, Pahor M, Furberg CD (1999) Assessment and control for confounding by indication in observational studies. J Am Geriatr Soc 47:749–754CrossRefPubMed Psaty BM, Koepsell TD, Lin D, Weiss NS, Siscovick DS, Rosendaal FR, Pahor M, Furberg CD (1999) Assessment and control for confounding by indication in observational studies. J Am Geriatr Soc 47:749–754CrossRefPubMed
14.
go back to reference Kirley K, Qato DM, Kornfield R, Stafford RS, Alexander GC (2012) National trends in oral anticoagulant use in the United States, 2007 to 2011. Circ Cardiovasc Qual Outcomes 5:615–621CrossRefPubMedPubMedCentral Kirley K, Qato DM, Kornfield R, Stafford RS, Alexander GC (2012) National trends in oral anticoagulant use in the United States, 2007 to 2011. Circ Cardiovasc Qual Outcomes 5:615–621CrossRefPubMedPubMedCentral
Metadata
Title
Clinical Features and Outcomes of Diffuse Alveolar Hemorrhage During Antithrombotic Therapy: A Retrospective Cohort Study
Authors
T. Otoshi
Y. Kataoka
A. Nakagawa
K. Otsuka
K. Tomii
Publication date
01-06-2016
Publisher
Springer US
Published in
Lung / Issue 3/2016
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-016-9873-4

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