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Article

Antithrombotic Therapy in Hereditary Hemorrhagic Telangiectasia: Real-World Data from the Gemelli Hospital HHT Registry

1
Multidisciplinary Gemelli Hospital Group for HHT, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, 00168 Rome, Italy
2
Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, 00168 Rome, Italy
3
Division of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, 00168 Rome, Italy
4
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
Multidisciplinary Gemelli Hospital Group for HHT: Giulio C. Passali, Maria E. Riccioni, Annalisa Tortora, Veronica Ojetti, Daniela Feliciani, Leonardo Stella, Clara De Simone, Luigi Corina, Alfredo Puca, Carmelo L. Sturiale, Laura Riccardi, Aldobrando Broccolini, Carmine Di StasiAndrea Contegiacomo, Annemilia Del Ciello, Pietro M. Ferraro, Emanuela Lucci-Cordisco, Giuseppe Zampino, Valentina Giorgio, Giuseppe Marrone, Gabriele Spoletini, Gabriella Locorotondo, Gaetano Lanza, Erica De Candia, Elisabetta Peppucci, Marianna Mazza, Giuseppe Marano, Maria T. Lombardi, Maria G. Brizzi, Silvia D’Ippolito, Mariaconsiglia Santantonio, Nico Attempati, Guido Costamagna.
J. Clin. Med. 2020, 9(6), 1699; https://doi.org/10.3390/jcm9061699
Received: 2 May 2020 / Revised: 25 May 2020 / Accepted: 27 May 2020 / Published: 2 June 2020
Although Hereditary Hemorrhagic Telangiectasia (HHT) is characterized by an overwhelming bleeding propensity, patients with this disease may also present medical conditions that require antithrombotic therapy (AT). However, precise information on indications, dosage, duration, effectiveness, and safety of AT in HHT patients is lacking. We performed a retrospective analysis of the HHT Registry of our University Hospital and found 26 patients who received AT for a total of 30 courses (19 courses of anticoagulant therapy and 11 courses of antiplatelet therapy). Indications to treatments included: atrial fibrillation, venous thrombosis and pulmonary embolism, heart valve replacement, retinal artery occlusion, secondary prevention after either stroke or myocardial infarction, and thromboprophylaxis for surgery. The total time of exposure to antiplatelet therapy was 385 months and to anticoagulant therapy 169 months. AT was generally well tolerated, with no fatal bleedings and no significant changes in hemoglobin levels. However, we found three major bleedings, with an incidence rate of 6.5 per 100 patients per year. When only patients treated with anticoagulants were considered, the incidence rate of major bleedings increased to 21.6 per 100 patients per year. Our study indicates that major bleeding may occur in HHT patients receiving AT, with a substantially increased rate in those treated with anticoagulants. Further studies are needed to fully estimate the tolerability of antithrombotic drugs in HHT. View Full-Text
Keywords: Hereditary Hemorrhagic Telangiectasia; antithrombotic therapy; anticoagulants; antiplatelets; bleeding; safety Hereditary Hemorrhagic Telangiectasia; antithrombotic therapy; anticoagulants; antiplatelets; bleeding; safety
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MDPI and ACS Style

Gaetani, E.; Agostini, F.; Giarretta, I.; Porfidia, A.; Di Martino, L.; Gasbarrini, A.; Pola, R.; on behalf of the Multidisciplinary Gemelli Hospital Group for HHT. Antithrombotic Therapy in Hereditary Hemorrhagic Telangiectasia: Real-World Data from the Gemelli Hospital HHT Registry. J. Clin. Med. 2020, 9, 1699. https://doi.org/10.3390/jcm9061699

AMA Style

Gaetani E, Agostini F, Giarretta I, Porfidia A, Di Martino L, Gasbarrini A, Pola R, on behalf of the Multidisciplinary Gemelli Hospital Group for HHT. Antithrombotic Therapy in Hereditary Hemorrhagic Telangiectasia: Real-World Data from the Gemelli Hospital HHT Registry. Journal of Clinical Medicine. 2020; 9(6):1699. https://doi.org/10.3390/jcm9061699

Chicago/Turabian Style

Gaetani, Eleonora, Fabiana Agostini, Igor Giarretta, Angelo Porfidia, Luigi Di Martino, Antonio Gasbarrini, Roberto Pola, and on behalf of the Multidisciplinary Gemelli Hospital Group for HHT. 2020. "Antithrombotic Therapy in Hereditary Hemorrhagic Telangiectasia: Real-World Data from the Gemelli Hospital HHT Registry" Journal of Clinical Medicine 9, no. 6: 1699. https://doi.org/10.3390/jcm9061699

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