Comparative influence of bleeding and ischemic risk factors on diabetic patients undergoing percutaneous coronary intervention with everolimus‐eluting stents
Autor: | Anastasios Roumeliotis, Sripal Bangalore, Ashok Seth, Marco Valgimigli, Ridhima Goel, Deepak L. Bhatt, Rishi Chandiramani, Moritz Blum, Junbo Ge, Franz-Josef Neumann, Lijuan Wang, Giulio G. Stefanini, James B. Hermiller, Roxana Mehran, Dominick J. Angiolillo, Davide Cao, Ken Kozuma, Kai Koo, Rajendra M Makkar, Mitchell W. Krucoff, Shigeru Saito |
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Přispěvatelé: | University of Zurich, Mehran, Roxana |
Rok vydání: | 2020 |
Předmět: |
Acute coronary syndrome
medicine.medical_specialty medicine.medical_treatment Population Hemorrhage 610 Medicine & health Coronary Artery Disease 030204 cardiovascular system & hematology 11171 Cardiocentro Ticino 2705 Cardiology and Cardiovascular Medicine 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Risk Factors Internal medicine Diabetes Mellitus Humans 2741 Radiology Nuclear Medicine and Imaging Medicine Radiology Nuclear Medicine and imaging Everolimus 030212 general & internal medicine Myocardial infarction education Stroke Aged education.field_of_study business.industry Percutaneous coronary intervention Stent Drug-Eluting Stents General Medicine medicine.disease Treatment Outcome Conventional PCI Cardiology Stents Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors Mace |
Zdroj: | Catheterization and Cardiovascular Interventions. 98:1111-1119 |
ISSN: | 1522-726X 1522-1946 |
Popis: | Objective To investigate the impact of ischemic and bleeding risk factors on long-term clinical outcomes of patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents. Background Second-generation drug-eluting stents have substantially improved outcomes after PCI in the general population; however, DM patients continue to experience high rates of ischemic and bleeding complications. Methods DM patients from the pooled XIENCE V registry were divided into high or low bleeding and ischemic risk groups (HBR, LBR, HIR, and LIR) based on established bleeding (age ≥ 75 years; chronic kidney disease; anemia; prior stroke; oral anticoagulation; thrombocytopenia; prior major bleeding) and ischemic (acute coronary syndrome; prior myocardial infarction [MI]; ≥3 stents implanted; ≥3 vessels treated; ≥3 lesions treated; stent length > 60 mm; bifurcation treated with ≥2 stents; chronic total occlusion) risk factors. The primary outcomes were major adverse cardiac events (MACE; cardiac death, MI, or stent thrombosis) and major bleeding at 4-year follow-up. Results A total of 3,704 DM patients were divided into four groups (21.5% LBR/LIR; 39.0% LBR/HIR; 15.6% HBR/LIR; 23.9% HBR/HIR). Compared with LBR/LIR patients, those at HBR/HIR and HBR/LIR had a significantly higher risk of MACE (HR (95% CI) 2.7 (1.9-3.9) and 2.2 (1.5-3.2), respectively) and major bleeding (2.7 (1.6-4.8) and 2.6 (1.4-4.7), respectively), while LBR/HIR patients did not. Conclusions Among DM patients undergoing PCI, presence of bleeding risk factors was associated with a higher risk of both ischemic and bleeding events, whereas commonly used features of ischemic risk did not impact long-term clinical outcomes. |
Databáze: | OpenAIRE |
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