Effects of thienopyridine class antiplatelets on bleeding outcomes following robot-assisted radical prostatectomy

被引：2

作者：

Kubota, Masashi ^{[1
,2
,3
]}

Kawakita, Mutsushi ^{[2
]}

Yoshida, Satomi ^{[3
]}

Kimura, Hiroko ^{[1
]}

Sumiyoshi, Takayuki ^{[1
]}

Yamasaki, Toshinari ^{[2
]}

Okumura, Kazuhiro ^{[4
]}

Yoshimura, Koji ^{[5
]}

Matsui, Yoshiyuki ^{[6
]}

Sugiyama, Kyohei ^{[7
]}

Okuno, Hiroshi ^{[8
]}

Segawa, Takehiko ^{[9
]}

Shimizu, Yosuke ^{[10
]}

Ito, Noriyuki ^{[11
]}

Onishi, Hiroyuki ^{[12
]}

Ishitoya, Satoshi ^{[13
]}

Soda, Takeshi ^{[14
]}

Yoshida, Toru ^{[15
]}

Uemura, Yuichi ^{[16
]}

Iwamura, Hiroshi ^{[17
]}

Okubo, Kazutoshi ^{[18
]}

Suzuki, Ryosuke ^{[19
]}

Fukuzawa, Shigeki ^{[20
]}

Akao, Toshiya ^{[21
]}

Kurahashi, Ryoma ^{[22
]}

Shimatani, Kimihiro ^{[23
]}

Sekine, Yuya ^{[24
]}

Negoro, Hiromitsu ^{[25
]}

Akamatsu, Shusuke ^{[26
]}

Kamoto, Toshiyuki ^{[27
]}

Ogawa, Osamu ^{[1
,13
]}

Kawakami, Koji ^{[3
]}

Kobayashi, Takashi ^{[1
]}

Goto, Takayuki ^{[1
]}

机构：

[1] Kyoto Univ Grad Sch Med, Dept Urol, Kyoto, Japan

[2] Kobe City Med Ctr Gen Hosp, Dept Urol, Kobe, Hyogo, Japan

[3] Kyoto Univ, Grad Sch Med & Publ Hlth, Dept Pharmacoepidemiol, Kyoto, Japan

[4] Tenri Yorozu Hosp, Dept Urol, Nara, Japan

[5] Shizuoka Prefectural Gen Hosp, Dept Urol, Shizuoka, Japan

[6] Natl Canc Ctr, Dept Urol, Tokyo, Japan

[7] Kurashiki Cent Hosp, Dept Urol, Okayama, Japan

[8] Natl Hosp Org Kyoto Med Ctr, Dept Urol, Kyoto, Japan

[9] Kyoto City Hosp, Dept Urol, Kyoto, Japan

[10] Kobe City Nishi Kobe Med Ctr, Dept Urol, Kobe, Hyogo, Japan

[11] Japanese Red Cross Wakayama Med Ctr, Dept Urol, Wakayama, Japan

[12] Japanese Red Cross Osaka Hosp, Dept Urol, Osaka, Japan

[13] Japanese Red Cross Otsu Hosp, Dept Urol, Otsu, Shiga, Japan

[14] Kitano Hosp, Dept Urol, Osaka, Japan

[15] Shiga Gen Hosp, Dept Urol, Moriyama, Shiga, Japan

[16] Toyooka Hosp, Dept Urol, Toyooka, Hyogo, Japan

[17] Himeji Med Ctr, Dept Urol, Himeji, Hyogo, Japan

[18] Kyoto Katsura Hosp, Dept Pathol, Kyoto, Japan

[19] Numazu City Hosp, Dept Urol, Shizuoka 4100302, Japan

[20] Shimada Gen Med Ctr, Dept Hematol, Shizuoka, Japan

[21] Rakuwakai Otowa Hosp, Dept Urol, Kyoto, Japan

[22] Kumamoto Univ, Fac Life Sci, Dept Urol, Kumamoto, Japan

[23] Hyogo Med Univ, Dept Urol, Nishinomiya, Hyogo, Japan

[24] Akita Univ Grad Sch Med, Dept Urol, Akita, Japan

[25] Univ Tsukuba, Dept Urol, Tsukuba, Ibaraki, Japan

[26] Nagoya Univ, Dept Urol, Nagoya, Aichi, Japan

[27] Miyazaki Univ, Dept Urol, Miyazaki, Japan

来源：

SCIENTIFIC REPORTS | 2024年 / 14卷 / 01期

关键词：

Bleeding; Prostatectomy; Antiplatelet agents; Aspirin; Clopidogrel; PERIOPERATIVE ANTICOAGULANT-THERAPY; LOW-DOSE ASPIRIN; SURGICAL COMPLICATIONS; CLOPIDOGREL; MULTICENTER; CLASSIFICATION; METAANALYSIS; MANAGEMENT; DISEASE; STROKE;

D O I：

10.1038/s41598-024-56570-9

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

This study aimed to assess the effects of thienopyridine-class antiplatelet agents (including ticlopidine, clopidogrel, and prasugrel) on bleeding complications in patients who underwent robot-assisted radical prostatectomy. This cohort study used a database for robot-assisted radical prostatectomy at 23 tertiary centers nationwide between 2011 and 2022. Patients who received thienopyridines (thienopyridine group) were compared with those who received aspirin monotherapy (aspirin group). The primary outcome was the incidence of bleeding complications. High-grade complications were defined as Clavien-Dindo grade III or higher. The risks of these outcomes were evaluated using inverse probability of treatment weighted regression models. The study results demonstrated that thienopyridine therapy was associated with a higher risk of overall bleeding complications (OR: 3.62, 95%CI 1.54-8.49). The increased risks of the thienopyridine group were detected for low-grade bleeding complications (OR: 3.20, 95%CI 1.23-8.30) but not for high-grade bleeding complications (OR: 5.23, 95%CI 0.78-34.9). The increased risk of bleeding complications was not observed when thienopyridine was discontinued (OR: 2.52, 95%CI 0.83-7.70); however, it became apparent when it was continued perioperatively (OR: 4.35, 95%CI 1.14-16.61). In conclusion, thienopyridine increased the incidence of bleeding complications, particularly low-grade bleeding complications, following robot-assisted radical prostatectomy. These bleeding effects emerged when thienopyridine was continued perioperatively.

引用

页数：10

共 26 条

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