{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:06:05Z","timestamp":1777943165691,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term antiplatelet treatment is associated with major bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine the costs associated with major bleeding in patients treated with aspirin-based antiplatelet treatment for secondary prevention of vascular events without routine prescription of proton-pump inhibitors and to estimate the likely long-term savings from routine co-prescription.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective population-based cohort study of TIA, ischemic stroke, and MI treated with antiplatelet drugs, we evaluated hospital care costs associated with bleed management during 10-year follow-up. Bleeding-associated costs were averaged across all patients. For upper GI-bleeds, mean costs were compared with the cost of routine co-prescription of proton-pump inhibitor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3166 patients on antiplatelet therapy with 405 first bleeding events, the average cost of major bleeding was $13,093 (S.D. 20,501), with similar costs for upper GI bleeds and intracranial bleeds ( p\u2009=\u20090.235). However, total costs among the 3166 patients were higher for upper GI bleeds ($1,158,385 vs. $740,123). Averaged across all patients, the 10-year cost of major bleeding was $838 (95%CI: 680\u20131007), $411 due to upper GI bleeding, the cost of which increased from $175 in those aged &lt;75 years to $644 at age \u226575 years ( p\u2009&lt;\u20090.0001). The corresponding costs of routine life-long co-prescription of proton-pump inhibitor to those patients not on prior treatment were $85 (84\u201388) and $39 (38\u201342).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In secondary prevention with aspirin-based antiplatelet treatment without routine proton-pump inhibitor use, the long-term costs of upper-GI bleeding at age \u226575 years are much higher than at younger age groups, and are at least 10-fold greater than the drug cost of routine co-prescription of proton-pump inhibitor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1747493019879658","type":"journal-article","created":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T21:45:48Z","timestamp":1569879948000},"page":"719-726","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Costs of bleeding on long-term antiplatelet treatment without routine co-prescription of proton-pump inhibitors"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2118-2662","authenticated-orcid":false,"given":"Ramon","family":"Luengo-Fernandez","sequence":"first","affiliation":[{"name":"Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3636-8355","authenticated-orcid":false,"given":"Linxin","family":"Li","sequence":"additional","affiliation":[{"name":"Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter M","family":"Rothwell","sequence":"additional","affiliation":[{"name":"Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"On Behalf of the Oxford Vascular Study","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"bibr1-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"bibr2-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.174516"},{"key":"bibr3-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60503-1"},{"key":"bibr4-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805819"},{"key":"bibr5-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30770-5"},{"key":"bibr6-1747493019879658","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i17.5382"},{"key":"bibr7-1747493019879658","volume-title":"British national formulary 72","author":"Joint Formulary Committee, 2017","year":"2017"},{"key":"bibr8-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2011.272"},{"key":"bibr9-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31388-6"},{"key":"bibr10-1747493019879658","unstructured":"Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L and Yusuf S. Adverse events related to proton pump inhibitor therapy. Results of a randomized trial of pantoprazole versus placebo with 53,152 patient years of follow-up. Paper presented at the United European Gastroenterology Week; October 20-24, 2018, Vienna, Austria. www.professionalabstracts.com\/ueg2018\/iplanner\/#\/presentation\/3544 (accessed 17 January 2018)."},{"key":"bibr11-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67702-1"},{"key":"bibr12-1747493019879658","unstructured":"Department of Health. NHS reference costs 2013 to 2014, www.gov.uk\/government\/publications\/nhs-reference-costs-2013-to-2014 (accessed 27 October 2017)."},{"key":"bibr13-1747493019879658","unstructured":"Personal Social Services Research Unit. Unit Costs of Health & Social Care 2016, www.pssru.ac.uk\/project-pages\/unit-costs\/unit-costs-2016\/ (accessed 27 October 2017)."},{"key":"bibr14-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00775.x"},{"key":"bibr15-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3515"},{"key":"bibr16-1747493019879658","unstructured":"Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L and Yusuf S. A randomized trial of proton pump inhibitors versus placebo to prevent upper gastrointestinal bleeding in patients receiving rivaroxaban or aspirin. Paper presented at the United European Gastroenterology Week; October 20-24, 2018, Vienna, Austria, www.professionalabstracts.com\/ueg2018\/iplanner\/#\/presentation\/3543 (accessed 17 January 2018)."},{"key":"bibr17-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl334"},{"key":"bibr18-1747493019879658","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.2012.01111.x"},{"key":"bibr19-1747493019879658","first-page":"1","volume":"15","author":"Squires D","year":"2015","journal-title":"Issue Brief"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493019879658","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1747493019879658","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493019879658","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:17:58Z","timestamp":1777706278000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1747493019879658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,30]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1177\/1747493019879658"],"URL":"https:\/\/doi.org\/10.1177\/1747493019879658","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,30]]}}}