New scoring model (DARSYM score) to predict post-discharge bleeding after successful second-generation drug-eluting stent implantation.
Heart Vessels
; 32(11): 1285-1295, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28560486
ABSTRACT
We aimed to create a scoring model to predict post-discharge bleeding (PDB) after drug-eluting stent (DES) implantation in Japanese subjects. We enrolled 1912 consecutive patients undergoing DES implantation (age 70 ± 10 years; 72% male). PDB was defined as a composite of type 5, 3, and 2 bleeding using the Bleeding Academic Research Consortium criteria. A Cox proportional hazard model assessed predictors, and we then derived a clinical model stratifying risk of PDB after DES implantation. Ninety-eight patients (6.7%) experienced PDB; gastrointestinal bleeding (GIB) was most common (n = 66, 67%), followed by intracranial bleeding (n = 24, 25%). PDB was independently associated with age >80 years [risk ratio (RR) 1.89, p < 0.001], hypertension (RR 1.68, p = 0.03), severe renal dysfunction (RR 1.56, p = 0.04), anemia on admission (RR 1.75, p = 0.02), prior history of GIB (RR 3.49, p < 0.001), NSAIDs use (RR 2.33, p = 0.03), and introduction of triple antithrombotic therapy (RR 2.94, p < 0.001). A clinical prediction rule for risk of bleeding events including seven baseline factors was derived. A better predictive ability for PDB was found using this new scoring system than the HAS-BLED score [c statistics, 0.85 (95% CI 0.83-0.87) and c statistics, 0.71 (95% CI 0.69-0.73), respectively; p < 0.001]. This new scoring system including patient characteristics and laboratory variables can identify patients at high risk of PDB after DES implantation.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
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Medição de Risco
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Hemorragia Pós-Operatória
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Stents Farmacológicos
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Intervenção Coronária Percutânea
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
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Humans
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Male
País/Região como assunto:
Asia
Idioma:
En
Revista:
Heart Vessels
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Japão