Evaluation of the Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients Bleeding Score for Predicting the Long-term Out-of-hospital Bleeding Risk in Chinese Patients after Percutaneous Coronary Intervention.
Chin Med J (Engl)
; 131(12): 1406-1411, 2018 Jun 20.
Article
in En
| MEDLINE
| ID: mdl-29595186
ABSTRACT
BACKGROUND:
The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients (PARIS) bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention (PCI). However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score's predictive value of bleeding in patients after PCI in the Chinese population.METHODS:
We performed a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China. We defined the primary end point as major bleeding (MB) according to Bleeding Academic Research Consortium definition criteria including Type 2, 3, or 5. The predictive value of the PARIS bleeding score was assessed with the area under the receiver operating characteristic (AUROC) curve.RESULTS:
Of 9782 patients, 245 (2.50%) MB events occurred during the 2 years of follow-up. The PARIS bleeding score was significantly higher in the MB group than that of non-MB group (4.00 [3.00, 5.00] vs. 3.00 [2.00, 5.00], Z = 3.71, P < 0.001). According to risk stratification of the PARIS bleeding score, the bleeding risk in the intermediate- and high-risk groups was 1.50 times (hazard ratio [HR] 1.50; 95% confidence interval [CI] 1.160-1.950; P = 0.002) and 2.27 times higher (HR 2.27; 95% CI 1.320-3.900; P = 0.003) than that in the low-risk group. The PARIS bleeding score showed a moderate predictive value for MB in the overall population (AUROC 0.568, 95% CI 0.532-0.605; P < 0.001) and acute coronary syndrome (ACS) subgroup (AUROC 0.578, 95% CI 0.530-0.626; P = 0.001) and tended to be predictive in the non-ACS subgroup (AUROC 0.556, 95% CI 0.501-0.611; P = 0.054).CONCLUSION:
The PARIS bleeding score shows good clinical value for risk stratification and has a significant, but relatively limited, prognostic value for out-of-hospital bleeding in the Chinese population after PCI.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Percutaneous Coronary Intervention
/
Hemorrhage
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Chin Med J (Engl)
Year:
2018
Document type:
Article
Affiliation country: