Session Title: Vitreoretinal Surgery I
Session Date/Time: Thursday 17/09/2015 | 08:30-10:30
Paper Time: 09:10
First Author: : M.Gallice FRANCE
Co Author(s): : F. Rouberol J. Leynaud P. Karine R. JeanPaul A. Pierre C. Chiquet
PURPOSE:To determine the prevalence of antiplatelet agents and anticoagulant therapy in a vitreoretinal surgery cohort.
1313 consecutive patients undergoing vitreoretinal surgery were prospectively included over 23 months in a multicentric study.
Patients were recruited from three vitreoretinal centers. If the patient required more than one surgery for one or both eyes, only the first one was considered. Data on anticoagulant and antiplatelet agents were gathered for dosage, interruption, maintenance, bridging, and indications for treatment. The number of subjects required in a randomized trial was estimated to test the hypothesis that hemorrhagic event incidence would decrease by 50% with antithrombotic discontinuation, with an alpha risk of 0.05 and a beta risk of 0.80.
Of the 1313 patients enrolled in the study, 235 (18%) were treated with at least one APA, including three patients treated with a new APA, prasugrel. Eighty-seven patients (6.5%) were taking AC. New oral anticoagulant therapy was reported in 12 cases (0.9%). Combined use of APA and AC was observed in 5% of the cases (n=11).
According to an estimated 14.6% frequency of a postoperative hemorrhagic event and the reported frequency of APA and AC use, over 50,800 patients would have to be screened to include 3722 patients per group in a randomized trial in order to test the hypothesis that hemorrhagic complications would be reduced by 50% if antithrombotics were stopped.