TY  - BOOK
AU  - Alraies, M Chadi
AU  - Ben-Dor, Itsik
AU  - Buchanan, Kyle
AU  - Gai, Jiaxiang
AU  - Koifman, Edward
AU  - Lee, Sang Yeub
AU  - Lipinski, Michael J
AU  - Pichard, Augusto D
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Steinvil, Arie
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Effect of Bleeding Risk on Type of Stent Used in Patients Presenting With Acute Coronary Syndrome
SN  - 0002-9149
PY  - 2017///
KW  - *Acute Coronary Syndrome/su [Surgery]
KW  - *Drug-Eluting Stents/ae [Adverse Effects]
KW  - *Percutaneous Coronary Intervention/mt [Methods]
KW  - *Postoperative Hemorrhage/et [Etiology]
KW  - *Risk Assessment/mt [Methods]
KW  - Acute Coronary Syndrome/di [Diagnosis]
KW  - Aged
KW  - District of Columbia/ep [Epidemiology]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Percutaneous Coronary Intervention/ae [Adverse Effects]
KW  - Postoperative Hemorrhage/ep [Epidemiology]
KW  - Prosthesis Failure
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Time Factors
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - Patients at high bleeding risk (HBR) are at increased risk of bleeding following percutaneous coronary intervention (PCI) with drug-eluting stents (DES) due to the need for longer dual antiplatelet duration. We sought to evaluate the likelihood of receiving DES during PCI in HBR populations and to characterize DES utilization trends over time. Consecutive patients who underwent PCI from April 2003 to September 2015 were identified. HBR is defined as patients fulfilling 1 or more of the HBR criteria: age >=75 years, anticoagulation use at discharge, history of stroke, cancer in previous 3 years, glucocorticoid use, hemoglobin (Hgb)<11g/dl, platelet count <100,000/mm<sup>3</sup>, or creatinine clearance (CCr)<40ml/min. Multivariate analysis was performed to identify which variables predicted DES selection. There were 10,594 patients (41.6%) who the met HBR definition. When adjusting for known risk factors, HBR patients were less likely to receive a DES compared with non-HBR patients (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.54 to 0.62, p<0.001). A preprocedural Hgb <11g/dl had the greatest association with choosing DES during PCI (OR 0.51, 95% CI 0.45 to 0.57, p<0.001). Within the HBR patients, having 3 or more HBR criteria versus <3 HBR criteria had lower likelihood of receiving a DES (OR 0.50, 95% CI 0.44 to 0.57, p<0.001). In conclusion, presence of HBR has a significant impact upon the decision to use DES. Copyright (c) 2017 Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.amjcard.2017.07.013
ER  -