Bleeding Risk Profile in Patients on Oral Anticoagulation Undergoing Percutaneous Coronary Interventions: A Prospective 24 Months Cohort Study
| Autor: | Tibor Huwyler, Sara Schukraft, Sonja Lehmann, Stéphane Cook, Jean-Christophe Stauffer, Ezia Cook, Diego Arroyo, Daphné Doomun, Cindy Ottiger-Mankaka, Jean-Jacques Goy, Serban Puricel, Ianis Doomun, Mario Togni |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
oral anticoagulation
medicine.medical_specialty Percutaneous business.industry triple antithrombotic therapy medicine.medical_treatment Hazard ratio percutaneous coronary intervention Psychological intervention Percutaneous coronary intervention Cardiovascular Medicine ACR-HBR criteria Internal medicine RC666-701 Antithrombotic Clinical endpoint medicine high bleeding risk Population study Diseases of the circulatory (Cardiovascular) system Cardiology and Cardiovascular Medicine business Original Research Cohort study |
| Zdroj: | Frontiers in Cardiovascular Medicine, Vol 8 (2021) Frontiers in Cardiovascular Medicine |
| DOI: | 10.3389/fcvm.2021.589426/full |
| Popis: | Background: The Academic Research Consortium has identified a set of major and minor risk factors in order to standardize the definition of a high bleeding risk (ACR-HBR). Oral anticoagulation is a major criterion frequently observed.Aims: The objective of this study is to quantify the risk of bleeding in patients on oral anticoagulation with at least one additional major ACR-HBR criteria in the Cardio-Fribourg Registry.Methods: Between 2015 and 2017, consecutive patients undergoing percutaneous coronary intervention were prospectively included in the Cardio-Fribourg registry. The study population included patients with ongoing long-term oral anticoagulation (OAC) and planned to receive triple antithrombotic therapy. Patients were divided in two groups: patients on OAC with at least one additional major ACR-HBR criteria vs. patients on OAC without additional major ACR-HBR criteria. The primary endpoint was any bleeding during the 24-month follow-up. Secondary bleeding endpoint was defined as Bleeding Academic Research Classification (BARC) ≥3.Results: Follow-up was completed in 142 patients at high bleeding risk on OAC, of which 33 (23%) had at least one additional major ACR-HBR criteria. The rate of the primary endpoint was 55% in patients on OAC with at least one additional ACR-HBR criteria compared with 14% in patients on OAC without additional ACR-HBR criteria (hazard ratio, 3.88; 95%CI, 1.85–8.14; p < 0.01). Patients with additional major ACR-HBR criteria also experienced significantly higher rates of BARC ≥ 3 bleedings (39% at 24 months).Conclusion: The presence of at least one additional ACR-HBR criterion identifies patients on OAC who are at very high risk of bleeding after percutaneous coronary intervention. |
| Databáze: | OpenAIRE |
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