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Prevalence and Impact of High Bleeding Risk in Patients Undergoing Left Main Artery Disease PCI
- Source :
- JACC. Cardiovascular interventions. 14(22)
- Publication Year :
- 2021
-
Abstract
- The aim of this study was to determine the prevalence and prognostic impact of high bleeding risk (HBR), as determined by the Academic Research Consortium HBR criteria, in real-world patients undergoing left main (LM) percutaneous coronary intervention (PCI).LM PCI is often reserved for patients at increased risk for periprocedural adverse events. Patients at HBR represent a relevant percentage of this cohort, but their outcomes after LM PCI are still poorly investigated.All patients undergoing LM PCI between 2014 and 2017 at a tertiary care center were prospectively enrolled. Patients were defined as having HBR if they met at least 1 major or 2 minor Academic Research Consortium HBR criteria. The primary endpoint was the composite of all-cause death, myocardial infarction (MI), or stroke at 12 months.Among 619 enrolled patients, 55.3% were at HBR. The rate of the primary endpoint was 4-fold higher in patients at HBR compared with those without HBR (20.5% vs 4.9%; HR: 4.43; 95% CI: 2.31-8.48), driven by an increased risk for all-cause death (HR: 3.88; 95% CI: 1.88-8.02) and MI (HR: 6.18; 95% CI: 1.83-20.9). Rates of target vessel or lesion revascularization and stent thrombosis were comparable in the 2 groups. Bleeding occurred more frequently in patients at HBR (HR: 3.77; 95% CI: 1.83-7.76). Consistent findings were observed after Cox multivariable regression adjustment.Among patients undergoing LM PCI, those with HBR are at increased risk for all-cause death, MI, and bleeding. Conversely, rates of repeat revascularization and stent thrombosis were comparable, suggesting frailty and comorbidities as primary causes of worse outcomes in patients at HBR.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Percutaneous coronary intervention
Disease
Arteries
Coronary Artery Disease
medicine.anatomical_structure
Percutaneous Coronary Intervention
Treatment Outcome
Risk Factors
Internal medicine
Conventional PCI
medicine
Prevalence
Humans
In patient
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
Artery
Subjects
Details
- ISSN :
- 18767605
- Volume :
- 14
- Issue :
- 22
- Database :
- OpenAIRE
- Journal :
- JACC. Cardiovascular interventions
- Accession number :
- edsair.doi.dedup.....bd4efc27ad0fdbea325dfd0ded00956f