Bleeding Risk Assessment and Choice of Antiplatelet Treatment in Acute Coronary Syndrome Patients
DOI:
https://doi.org/10.70749/ijbr.v3i5.2522Keywords:
Bleeding Risk Assessment, Anti-Platelet Treatment, Acute Coronary Syndrome.Abstract
Background: Patients with coronary artery disease are usually treated with dual antiplatelet therapy after percutaneous coronary intervention and are at risk of both ischaemic and bleeding events. Prevention of bleeding is as important as prevention of ischemia. Objective: To determine the frequency of bleeding risk assessment and choice of antiplatelet treatment in acute coronary syndrome patients, at a tertiary care hospital, Karachi. Material and Methods: This cross-sectional study was conducted with 135 ACS patients of both gender with age 30-75 years. Bleeding risk assessment was conducted using CRUSADE scoring system with five categories i.e, very low (≤20), low (21–30), moderate (31–40), high (41–50), and very high (>50). The choice of antiplatelet therapy was evaluated accordingly. Statistical analysis was conducted using SPSS. Chi-square tests was applied to determine statistical significance, with a threshold of P ≤0.05. Results: The study had a male predominance (56.3%). NSTEMI was the most prevalent ACS subtypeand was significantly associated with higher bleeding risk (p=0.012), classified as very high risk. Hypertension and diabetes mellituswere strongly linked to increased bleeding risk (p<0.001 and p=0.001). Dual antiplatelet therapy was the preferred strategy, with aspirin+clopidogrel (40.7%) and aspirin+ticagrelor (34.1%) being the most frequently prescribed combinations (p<0.001). Conclusion: This study highlights significant variability in bleeding risk among ACS patients, with NSTEMI showing highest risk profile. Hypertension, diabetes mellitus, and family history of ACS were strongly associated with elevated bleeding risk, emphasizing need for individualized antiplatelet therapy selection.
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