Analysis of the effects of different antiplatelet therapy regimens on the prognosis of patients with epistaxis

Jia Hongguang; Wu Hao; Rao Yuansheng; Wang Jianhong

doi:10.3760/j.issn.1673-4777.2025.05.019

Abstract：Objective To investigate the effect of different antiplatelet therapy on the prognosis of patients with epistaxis.Methods The clinical data of 243 patients with epistaxis who were admitted to Beijing Anzhen Hospital,Capital Medical University from January 2020 to December 2023 were retrospectively analyzed.According to the use of antiplatelet drugs before epistaxis,78 patients with coronary atherosclerotic heart disease who took aspirin combined with ticagrelor or clopidogrel were divided into dual antibody group,83 patients who took single antiplatelet drugs were divided into single antibody group,and 82 patients who did not use antiplatelet drugs were divided into control group.The clinical and laboratory indexes,therapeutic effects and complications of epistaxis were compared among the three groups,and the related factors affecting the prognosis of epistaxis were analyzed.Results The proportions of multiple epistaxis(≥3 times within 1 month)and persistent epistaxis(≥30 minutes within 24 hours)in the dual antibody group were higher than those in the single antibody group and the control group(all P＜0.05).The cure rate of the double antibody group was lower than those of the control group and the single antibody group,and the recurrence rate was significantly higher than that of the control group[67.9％(53/78)vs 91.5％(75/82),81.9％(68/83);9.0％(7/78)vs 1.2％(1/82)](all P＜0.05).The total incidence of complications in the dual antibody group was higher than those in the control group and the single antibody group[25.6％(20/78)vs 8.5％(7/82),10.8％(9/83)](both P＜0.05).Logistic regression analysis showed that the possibility of healing of epistaxis within 1 month after dual antiplatelet therapy was significantly lower than that of the control group(odds ratio=1.759,95％confidence interval:1.032-5.925,P=0.034).Conclusions Dual antiplatelet therapy significantly increases the risk of severe epistaxis and has adverse effects on the prognosis of patients with epistaxis,which should be paid more attention.