Bleeding risk of pleural procedures in patients taking antiplatelet therapy: A multicentric prospective study

Introduction: When pleural procedures (PP) are required in patients receiving antiplatelet therapy (APT), the risk of bleeding with APT continuation must be balanced against the risk of arterial thrombosis with APT withdrawal. Currently, the bleeding risk of PP in patients with APT is unknown. Objectives: The study aimed at assessing the incidence of bleeding events (BE) after PP in patients receiving APT in comparison with controls. Methods: A prospective multicentric study was conducted in 18 respiratory care departments and 11 medical intensive care units. The occurrence of BE was considered within the 24 hours following PP performance. Results: 1133 PP were recorded: 130 (12%) blind pleural biopsies, 625 (55%) chest tube insertions, 378 (33%) thoracocentesis in 185 APT+ and 948 APT- subjects. APT+ subjects were more frequently males (89% vs 64%; p=0.02) and were older (73±13 vs 58±19 years; p In the APT+ group, there was a higher prevalence of renal failure (42% vs 23%; p Conclusion: In this study, APT was associated with a 3 folds increase in PP-related bleeding risk.