Effect of Bleeding Risk on Type of Stent Used in Patients Presenting With Acute Coronary Syndrome.

MedStar author(s):
Citation: American Journal of Cardiology. 120(8):1272-1278, 2017 Oct 15PMID: 28826893Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Acute Coronary Syndrome/su [Surgery] | *Drug-Eluting Stents/ae [Adverse Effects] | *Percutaneous Coronary Intervention/mt [Methods] | *Postoperative Hemorrhage/et [Etiology] | *Risk Assessment/mt [Methods] | Acute Coronary Syndrome/di [Diagnosis] | Aged | District of Columbia/ep [Epidemiology] | Female | Follow-Up Studies | Humans | Incidence | Male | Middle Aged | Percutaneous Coronary Intervention/ae [Adverse Effects] | Postoperative Hemorrhage/ep [Epidemiology] | Prosthesis Failure | Retrospective Studies | Risk Factors | Time FactorsYear: 2017Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: 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.All authors: Alraies MC, Ben-Dor I, Buchanan K, Gai J, Koifman E, Lee SY, Lipinski MJ, Pichard AD, Rogers T, Satler LF, Steinvil A, Torguson R, Waksman RFiscal year: FY2018Digital Object Identifier: Date added to catalog: 2017-08-29
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28826893 Available 28826893

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

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.

English

Powered by Koha