Masahiro Natsuaki1, Takeshi Morimoto2, Hiroki Shiomi3, Natsuhiko Ehara4, Ryoji Taniguchi5, Toshihiro Tamura6, Takeshi Tada7, Satoru Suwa8, Kazuhisa Kaneda9, Hirotoshi Watanabe3, Junichi Tazaki3, Shin Watanabe3, Erika Yamamoto3, Naritatsu Saito3, Masayuki Fuki3, Teruki Takeda10, Hiroshi Eizawa11, Eiji Shinoda12, Hiroshi Mabuchi10, Manabu Shirotani13, Takashi Uegaito14, Mitsuo Matsuda14, Mamoru Takahashi15, Moriaki Inoko16, Takashi Tamura17, Kazuhisa Ishii18, Tomoya Onodera19, Hiroki Sakamoto20, Takeshi Aoyama21, Yukihito Sato5, Kenji Ando22, Yutaka Furukawa4, Yoshihisa Nakagawa23, Kazushige Kadota7, Takeshi Kimura3. 1. Department of Cardiovascular Medicine, Saga University. 2. Department of Clinical Epidemiology, Hyogo College of Medicine. 3. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University. 4. Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital. 5. Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center. 6. Department of Cardiology, Tenri Hospital. 7. Department of Cardiology, Kurashiki Central Hospital. 8. Department of Cardiology, Juntendo University Shizuoka Hospital. 9. Department of Cardiology, Mitsubishi Kyoto Hospital. 10. Department of Cardiology, Koto Memorial Hospital. 11. Department of Cardiology, Kobe City Nishi-Kobe Medical Center. 12. Department of Cardiology, Hamamatsu Rosai Hospital. 13. Department of Cardiology, Kindai University Nara Hospital. 14. Department of Cardiology, Kishiwada City Hospital. 15. Department of Cardiology, Shimabara Hospital. 16. Department of Cardiology, Tazuke Kofukai Medical Research Institute, Kitano Hospital. 17. Department of Cardiology, Japanese Red Cross Wakayama Medical Center. 18. Department of Cardiology, Kansai Denryoku Hospital. 19. Department of Cardiology, Shizuoka City Shizuoka Hospital. 20. Department of Cardiology, Shizuoka General Hospital. 21. Division of Cardiology, Shimada Municipal Hospital. 22. Department of Cardiology, Kokura Memorial Hospital. 23. Department of Cardiology, Shiga University of Medical Science Hospital.
Abstract
BACKGROUND: The prevalence of and expected bleeding event rate in patients with the Japanese version of high bleeding risk (J-HBR) criteria are currently unknown in real-world percutaneous coronary intervention (PCI) practice.Methods and Results: We applied the J-HBR criteria in the multicenter CREDO-Kyoto registry cohort-3 that enrolled 13,258 consecutive patients who underwent first PCI. The J-HBR criteria included Japanese-specific major criteria such as heart failure, low body weight, peripheral artery disease and frailty in addition to the Academic Research Consortium (ARC)-HBR criteria. There were 8,496 patients with J-HBR, and 4,762 patients without J-HBR. The J-HBR criteria identified a greater proportion of patients with HBR than did ARC-HBR (64% and 48%, respectively). Cumulative incidence of the Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding was significantly higher in the J-HBR group than in the no-HBR group (14.0% vs. 4.1% at 1 year; 23.1% vs. 8.4% at 5 years, P<0.0001). Cumulative 5-year incidence of BARC 3/5 bleeding was 25.1% in patients with ARC-HBR, and 23.1% in patients with J-HBR. Cumulative incidence of myocardial infarction or ischemic stroke was also significantly higher in the J-HBR group than in the no-HBR group (6.9% vs. 3.6% at 1 year; 13.2% vs. 7.1% at 5 years, P<0.0001). CONCLUSIONS: The J-HBR criteria successfully identified those patients with very high bleeding risk after PCI, who represented 64% of patients in this all-comers registry.
BACKGROUND: The prevalence of and expected bleeding event rate in patients with the Japanese version of high bleeding risk (J-HBR) criteria are currently unknown in real-world percutaneous coronary intervention (PCI) practice.Methods and Results: We applied the J-HBR criteria in the multicenter CREDO-Kyoto registry cohort-3 that enrolled 13,258 consecutive patients who underwent first PCI. The J-HBR criteria included Japanese-specific major criteria such as heart failure, low body weight, peripheral artery disease and frailty in addition to the Academic Research Consortium (ARC)-HBR criteria. There were 8,496 patients with J-HBR, and 4,762 patients without J-HBR. The J-HBR criteria identified a greater proportion of patients with HBR than did ARC-HBR (64% and 48%, respectively). Cumulative incidence of the Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding was significantly higher in the J-HBR group than in the no-HBR group (14.0% vs. 4.1% at 1 year; 23.1% vs. 8.4% at 5 years, P<0.0001). Cumulative 5-year incidence of BARC 3/5 bleeding was 25.1% in patients with ARC-HBR, and 23.1% in patients with J-HBR. Cumulative incidence of myocardial infarction or ischemic stroke was also significantly higher in the J-HBR group than in the no-HBR group (6.9% vs. 3.6% at 1 year; 13.2% vs. 7.1% at 5 years, P<0.0001). CONCLUSIONS: The J-HBR criteria successfully identified those patients with very high bleeding risk after PCI, who represented 64% of patients in this all-comers registry.
Entities:
Keywords:
Coronary artery disease; High bleeding risk; Percutaneous coronary intervention