Abstract #43233
RELATIONSHIP BETWEEN MAJOR BLEEDING AND CONCURRENT USE OF ANTIPLATELET DRUGS WITH CHINESE MEDICATIONS
Tsai HH, Lin HW
China Medical University, Taichung, Taiwan
OBJECTIVES: While patients use Chinese medications (CM) concurrently with Western medications are
common in Taiwan, the use of CM products with antiplatelet agents might increase the bleeding risks.
The objective of this research was to explore the impact of major bleeding risk due to concurrent use of antiplatelet drugs with CMs ( American ginseng, Asian ginseng, danshen, and dong quai). METHODS: A nested case-control and case-crossover study using the 2007 National Health Insurance Research Databases in Taiwan was conducted. All outpatients who used aspirin, clopidogrel, dipyridamole, or ticlopidine continuously were included in the cohort. Those antiplatelet users hospitalized for major bleeding were in case group and the corresponding control group was randomly matched base on the propensity score. The case periods in case-crossover study were defined as 1-14 days before
hospitalization and 15-28 days or 71-84 days before hospitalization were control periods. The conditional logistic regression analyses were performed to determine the associations between major bleeding and exposure to interactions between antiplatelets and specific CM. RESULTS: Of the 92,046 antiplatelet users as the cohort, 1,095 patients (1.19%) were identified as cases and 887 patients were included in the case-crossover study. Concurrent use of antiplatelet drugs with specific single CM showed an increased risk of hospitalization due to major bleeding in both studies but was not statistically significant.
Antiplatelet drugs users were 28% to 152% more risk of major bleeding among those who used Asian ginseng or danshen currently than others. CONCLUSIONS: Relationship between major bleeding and concurrent use of antiplatelet drugs with CM was not ascertained. The adverse clinical outcomes due to concomitant use warrant further investigation.
