Average daily ischemic versus bleeding risk in patients with ACS undergoing PCI: Insights from the BleeMACS and RENAMI registries

被引：33

作者：

D'Ascenzo, Fabrizio ^{[1
]}

Biole, Carloalberto ^{[1
]}

Raposeiras-Roubin, Sergio ^{[2
]}

Gaido, Federico ^{[3
]}

Abu-Assi, Emad ^{[2
]}

Kinnaird, Tim ^{[4
]}

Ariza-Sole, Albert ^{[5
]}

Liebetrau, Christoph ^{[6
]}

Manzano-Fernandez, Sergio ^{[7
]}

Boccuzzi, Giacomo ^{[8
]}

Simao Henriques, Jose Paulo ^{[9
,10
]}

Templin, Christian ^{[11
]}

Wilton, Stephen B. ^{[12
]}

Omede, Pierluigi ^{[1
]}

Velicki, Lazar ^{[13
,14
]}

Xanthopoulou, Ioanna ^{[15
]}

Correia, Luis ^{[16
]}

Cerrato, Enrico ^{[17
]}

Rognoni, Andrea ^{[18
]}

Fabrizio, Ugo ^{[8
]}

Nunez-Gil, Ivan ^{[19
]}

Montabone, Andrea ^{[8
]}

Taha, Salma ^{[20
]}

Fujii, Toshiharu ^{[21
]}

Durante, Alessandro ^{[22
]}

Song, Xiantao ^{[23
]}

Gili, Sebastiano ^{[11
]}

Magnani, Giulia ^{[11
]}

Autelli, Michele ^{[1
]}

Bongiovanni, Federica ^{[1
]}

Grosso, Alberto ^{[1
]}

Kawaji, Tetsuma ^{[24
]}

Flores Blanco, Pedro ^{[7
]}

Garay, Alberto ^{[5
]}

Quadri, Giorgio ^{[17
]}

Alexopoulos, Dimitrios ^{[15
]}

Caneiro Queija, Berenice ^{[2
]}

Huczek, Zenon ^{[25
]}

Paz, Rafael Cobas ^{[2
]}

Ramon Gonzalez-Juanatey, Jose ^{[26
]}

Cespon Fernandez, Maria ^{[2
]}

Nie, Shao-Ping ^{[23
]}

Munoz Pousa, Isabel ^{[2
]}

Kawashiri, Masa-aki ^{[27
]}

Rettegno, Sara ^{[1
]}

Gallo, Diego ^{[28
]}

Morbiducci, Umberto ^{[28
]}

Conrotto, Federico ^{[1
]}

Dominguez-Rodriguez, Alberto ^{[9
]}

Valdes, Mariano ^{[7
]}

机构：

[1] Univ Torino, Dept Cardiol, Turin, Italy

[2] Univ Hosp Alvaro Cunqueiro, Dept Cardiol, Vigo, Spain

[3] Univ Torino, Turin, Italy

[4] Univ Hosp Wales, Cardiol Dept, Cardiff, Wales

[5] Univ Hosp Bellvitge, Dept Cardiol, Barcelona, Spain

[6] Kerckhoff Heart & Thorax Ctr, Frankfurt, Germany

[7] Univ Hosp Virgen Arrtixaca, Dept Cardiol, Murcia, Spain

[8] SG Bosco Hosp, Dept Cardiol, Turin, Italy

[9] Univ Hosp Canarias, Dept Cardiol, Tenerife, Spain

[10] Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands

[11] Univ Spital, Div Cardiol, Zurich, Switzerland

[12] Cardiovasc Inst Alberta, Calgary, AB, Canada

[13] Univ Novi Sad, Med Fac, Novi Sad, Serbia

[14] Inst Cardiovasc Dis Vojvodina, Sremska Kamenica, Serbia

[15] Univ Patras Hosp, Athens, Greece

[16] Escola Bahiana Med & Saude Publ, Salvador, BA, Brazil

[17] San Luigi Gonzaga Univ Hosp, Orbassano & Infermi Hosp, Intervent Unit, Turin, Italy

[18] Maggiore Carita Hosp, Catheterizat Lab, Novara, Italy

[19] San Carlos Hosp, Madrid, Spain

[20] Assiut Univ, Fac Med, Dept Cardiol, Assiut, Egypt

[21] Tokai Univ, Sch Med, Tokyo, Japan

[22] Osped Valduce, UO Cardiol, Como, Italy

[23] Anzhen Hosp, Beijing, Peoples R China

[24] Univ Grad Sch Med, Kyoto, Japan

[25] Univ Clin Hosp, Warsaw, Poland

[26] Univ Clin Hosp, Santiago De Compostela, Spain

[27] Kanazawa Univ, Div Cardiovasc Med, Grad Sch Med, Kanazawa, Ishikawa, Japan

[28] Politecn Torino, PolitoBIOMed Lab, Dept Mech & Aerosp Engn, Turin, Italy

[29] Sapienza Univ Rome, Dept Med Surg Sci & Biotechnol, Latina, Italy

[30] IRCCS Neuromed, Dept AngioCardioNeurol, Pozzilli, Italy

[31] Cardiovasc Res Fdn, Clin Trials Ctr, New York, NY USA

[32] Columbia Univ, New York Presbyterian Hosp, Med Ctr, New York, NY USA

来源：

AMERICAN HEART JOURNAL | 2020年 / 220卷

关键词：

ACUTE CORONARY SYNDROMES; CLOPIDOGREL; PRASUGREL; OUTCOMES; DISEASE; COMPLICATIONS; TICAGRELOR; MANAGEMENT; STENTS;

D O I：

10.1016/j.ahj.2019.10.001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The risk of recurrent ischemia and bleeding after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) may vary during the first year of follow-up according to clinical presentation, and medical and interventional strategies. Methods BIeeMACS and RENAMI are 2 multicenter registries enrolling patients with ACS treated with PCI and clopidogrel, prasugrel, or ticagrelor. The average daily ischemic and bleeding risks (ADIR and ADBR) in the first year after PCI were the primary end points. The difference between ADBR and ADIR was calculated to estimate the potential excess of bleeding/ischemic events in a given period or specific subgroup. Results A total of 19,826 patients were included. Overall, in the first year after PCI, the ADBR was 0.008085%, whereas ADIR was 0.008017% (P = .886). In the first 2 weeks ADIR was higher than ADBR = .013), especially in patients with ST-segment elevation myocardial infarction or incomplete revascularization. ADIR continued to be, albeit non-significantly, greater than ADBR up to the third month, whereas ADBR became higher, although not significantly, afterward. Patients with incomplete revascularization had an excess in ischemic risk (P = .003), whereas non-ST-segment elevation ACS patients and those on ticagrelor had an excess of bleeding (P = .012 and P = .022, respectively). Conclusions In unselected ACS patients, ADIR and ADBR occurred at similar rates within 1 year after PCI. ADIR was greater than ADBR in the first 2 weeks, especially in ST-segment elevation myocardial infarction patients and those with incomplete revascularization. In the first year, ADIR was higher than ADBR in patients with incomplete revascularization, whereas ADBR was higher in non-ST-segment elevation ACS patients and in those discharged on ticagrelor.

引用

页码：108 / 115

页数：8

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