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Frequency and predictors of bleeding events after 2nd generation drug-eluting stent implantation differ depending on time after implantation.

Abstract：

BACKGROUND:Antiplatelet therapy is required after drug-eluting stent (DES) implantation, but bleeding events occur unexpectedly. We aimed to assess whether bleeding event predictors after 2nd generation DES (2nd DES) implantation differed by time after implantation. METHODS:We studied 1912 consecutive patients who underwent successful 2nd DES implantation (70±10 years, 72% male). Bleeding events were recorded as early (≤1 year) and late (>1 year). Major bleeding events were defined as a composite of type 5, 3, and 2 bleeding in the Bleeding Academic Research Consortium criteria. Predictors were assessed using a Cox proportional hazard model. RESULTS:Bleeding event rates were 3.3%, 5.1%, and 6.7% at 1, 2, and 3 years, respectively, with the highest 1-year rate in year 1 (p<0.001). Cause and severity of bleeding events were similar between early and late bleeding events. Prior history of gastrointestinal bleeding, non-steroidal anti-inflammatory drug use, and triple antithrombotic therapy [adjusted risk ratio (RR): 3.68, 3.21, 4.57, respectively; p<0.01] were independent predictors of early bleeding events. Age >80 years and severe renal dysfunction (adjusted RR: 2.27, 2.02, respectively; p<0.01) were independent predictors of late bleeding events. Survival rate was significantly lower in patients with bleeding events compared with patients without bleeding events (82.4% vs 90.1%; p<0.001). CONCLUSION:Frequency and predictors of bleeding events after 2nd DES implantation differ by time after implantation. Treatment strategies corresponding to individual patients are required.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Honda Y,Yamawaki M,Mori S,Shirai S,Makino K,Tokuda T,Maruyama T,Takafuji H,Takama T,Tsutumi M,Sakamoto Y,Takimura H,Kobayashi N,Araki M,Hirano K,Sakai T,Ito Y

doi

10.1016/j.jjcc.2016.05.017

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

632-639

issue

4

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(16)30107-1

journal_volume

69

pub_type

杂志文章

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