Ischemic and Bleeding Events in PENDULUM Patients With High Bleeding Risk and High Platelet Reactivity.
Circ J
; 86(5): 763-771, 2022 04 25.
Article
en En
| MEDLINE
| ID: mdl-34880154
ABSTRACT
BACKGROUND:
The balance between thrombotic and bleeding risk is of great concern in high bleeding risk (HBR) patients. This study evaluated the relationship between perioperative antiplatelet reactivity and thrombotic and bleeding events in patients at HBR undergoing percutaneous coronary intervention (PCI).MethodsâandâResults:
In this post hoc analysis of the PENDULUM (Platelet rEactivity in patieNts with DrUg eLUting stent and balancing risk of bleeding and ischeMic event) registry, patients undergoing PCI were categorized as HBR or non-HBR, and stratified as having high platelet reactivity (HPR; P2Y12reaction unit [PRU] >208) or non-HPR (PRU ≤208). Cumulative incidences of cardiovascular and cerebrovascular events (Journal of the American College of Cardiology expert definitions) and bleeding events (Bleeding Academic Research Consortium criteria) were assessed 12 months after index PCI. The incidence of ischemic and bleeding events was ~3-fold higher in HBR vs. non-HBR patients. Thrombotic/ischemic events were significantly more common in the HPR subgroup in HBR patients (hazard ratio [HR] 1.59; 95% confidence interval [CI] 1.11-2.28; P=0.012), but there was no difference in non-HBR patients. After adjustment for covariates, HPR in HBR patients remained an independent factor for thrombotic and ischemic events (HR 1.69; 95% CI 1.13-2.54; P=0.011), but not for bleeding events (HR 1.56; 95% CI 0.78-3.11; P=0.210).CONCLUSIONS:
Maintaining adequate PRU levels during PCI is an important factor in improving clinical outcomes, especially for HBR patients.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Trombosis
/
Stents Liberadores de Fármacos
/
Intervención Coronaria Percutánea
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Circ J
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2022
Tipo del documento:
Article