Prevalence of the Japanese high bleeding risk criteria and its prognostic significance for fatal bleeding in patients with acute myocardial infarction

被引:8
作者
Sotomi, Yohei [1 ,3 ]
Hikoso, Shungo [1 ,3 ]
Nakatani, Daisaku [1 ,3 ]
Suna, Shinichiro [1 ,3 ]
Dohi, Tomoharu [1 ,3 ]
Mizuno, Hiroya [1 ,3 ]
Okada, Katsuki [1 ,2 ,3 ]
Kida, Hirota [1 ,3 ]
Oeun, Bolrathanak [1 ,3 ]
Sunaga, Akihiro [1 ,3 ]
Sato, Taiki [1 ,3 ]
Kitamura, Tetsuhisa [2 ,3 ]
Sakata, Yasuhiko [3 ,4 ]
Sato, Hiroshi [3 ,5 ]
Hori, Masatsugu [3 ,6 ]
Komuro, Issei [3 ,7 ]
Sakata, Yasushi [1 ,3 ]
机构
[1] Osaka Univ, Dept Cardiovasc Med, Grad Sch Med, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan
[2] Osaka Univ, Grad Sch Med, Dept Social & Environm Med, Div Environm Med & Populat Sci, Osaka, Japan
[3] Osaka Univ, Dept Genome Informat, Grad Sch Med, Osaka, Japan
[4] Tohoku Univ, Dept Cardiovasc Med, Grad Sch Med, Sendai, Miyagi, Japan
[5] Kwansei Gakuin Univ, Sch Human Welf Studies, Hlth Care Ctr & Clin, Nishinomiya, Hyogo, Japan
[6] Osaka Int Canc Inst, Osaka, Japan
[7] Univ Tokyo, Dept Cardiovasc Med, Grad Sch Med, Tokyo, Japan
关键词
High bleeding risk; Academic Research Consortium; Japanese; Acute myocardial infarction;
D O I
10.1007/s00380-021-01836-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The Japanese high-bleeding-risk criteria (Japanese-HBR), modified criteria of the Academic Research Consortium (ARC) HBR, has been recently proposed. We aimed to investigate the prevalence of the ARC-HBR and the Japanese-HBR, and to assess their prognostic significance in patients with acute myocardial infarction (AMI). Methods and Results We applied the ARC-HBR and the Japanese-HBR criteria to the OACIS prospective multicenter acute myocardial infarction registry (12,093 patients, 66 +/- 12 years, 9,096 males). The primary endpoint was fatal bleeding (BARC-5). Median follow-up duration was 4.84 [inter-quartile range 1.35, 5.01] years. Prevalence of the ARC-HBR was 43.8%, while that of the Japanese-HBR was 61.8%. Cumulative incidence of fatal bleeding was higher in the ARC-HBR group than in the no ARC-HBR group at 1 year (1.3 vs. 0.6%) and at 5 years (2.0 vs. 0.7%). The Kaplan-Meier curves stratified by the Japanese-HBR criteria more prominently diverged (1.3 vs. 0.2% at 1 year; and 1.9 vs. 0.3% at 5 years). The Japanese-HBR criteria showed superior discriminative performance over the ARC-HBR criteria (C-statistics: 0.677 vs. 0.598, P < 0.001). Conclusions In the real-world Japanese AMI registry, nearly half of the patients fulfilled the criteria of ARC-HBR, and two-thirds met the Japanese-HBR. Our findings support the validity of both ARC- and Japanese-HBR criteria in AMI patients but encourage the future application of the Japanese-HBR criteria to the Japanese AMI cohort.
引用
收藏
页码:1484 / 1495
页数:12
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