Haoyu Wang (China)
Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Department of Cardiology, Coronary Heart Disease CenterAuthor Of 2 Presentations
Live Q&A (ID 1551)
O063 - Prognostic Impact of High Ischemic Risk (ESC/EACTS guidelines on myocardial revascularization) Versus High Bleeding Risk (PRECISE-DAPT score) on Clinical Outcomes After Percutaneous Coronary Intervention (ID 1423)
Abstract
Background and Aims
The clinical outcome after percutaneous coronary intervention (PCI) is affected by various ischemic and bleeding risk factors. We investigated the relative impact of high ischemic risk (ESC/EACTS guidelines on myocardial revascularization definitions) versus high bleeding risk (PRECISE-DAPT score≥25) on clinical outcomes after PCI.
Methods
A total of 10,167 consecutive patients undergoing PCI from prospective Fuwai PCI Registry were reviewed. ESC/EACTS–HIR features was defined as having at least one of the eight clinical and angiographic characteristics. The primary ischemic endpoint was target vessel failure (cardiac death, target vessel myocardial infarction [MI], or target vessel revascularization [TVR]); bleeding outcome was assessed using the BARC type 2, 3, or 5 bleeding. Median follow-up was 29 months.
Results
Compared with non-HIR patients, HIR patients (n=5,149, 50.6%) were associated with increased risk for target vessel failure (adjusted hazard ratio [HRadjust]: 1.48 [1.25-1.74]) and patient-oriented composite outcome (HRadjust: 1.44 [1.28-1.63]), as well as cardiac death, MI, and TVR. In contrast, the risk of clinically relevant bleeding was not significantly different between the 2 groups. (HRadjust: 0.84 [0.66-1.06]). According to the definitions of PRECISE-DAPT score≥25, HBR patients incurred an increased risk not only of bleeding but also of multiple ischemic events. There was no significant interaction between HBR status and clinical outcomes associated with ESC/EACTS-HIR criteria (all Pinteraction>0.05).
Conclusions
ESC/EACTS-high ischemic risk and high bleeding risk (PRECISE-DAPT score≥25) were both significant predictors for ischemic clinical events in patients undergoing PCI. However, ESC/EACTS-high ischemic risk had a greater and more prolonged effect on outcomes than high bleeding risk (PRECISE-DAPT score ≥ 25).
Presenter of 2 Presentations
Live Q&A (ID 1551)
O063 - Prognostic Impact of High Ischemic Risk (ESC/EACTS guidelines on myocardial revascularization) Versus High Bleeding Risk (PRECISE-DAPT score) on Clinical Outcomes After Percutaneous Coronary Intervention (ID 1423)
Abstract
Background and Aims
The clinical outcome after percutaneous coronary intervention (PCI) is affected by various ischemic and bleeding risk factors. We investigated the relative impact of high ischemic risk (ESC/EACTS guidelines on myocardial revascularization definitions) versus high bleeding risk (PRECISE-DAPT score≥25) on clinical outcomes after PCI.
Methods
A total of 10,167 consecutive patients undergoing PCI from prospective Fuwai PCI Registry were reviewed. ESC/EACTS–HIR features was defined as having at least one of the eight clinical and angiographic characteristics. The primary ischemic endpoint was target vessel failure (cardiac death, target vessel myocardial infarction [MI], or target vessel revascularization [TVR]); bleeding outcome was assessed using the BARC type 2, 3, or 5 bleeding. Median follow-up was 29 months.
Results
Compared with non-HIR patients, HIR patients (n=5,149, 50.6%) were associated with increased risk for target vessel failure (adjusted hazard ratio [HRadjust]: 1.48 [1.25-1.74]) and patient-oriented composite outcome (HRadjust: 1.44 [1.28-1.63]), as well as cardiac death, MI, and TVR. In contrast, the risk of clinically relevant bleeding was not significantly different between the 2 groups. (HRadjust: 0.84 [0.66-1.06]). According to the definitions of PRECISE-DAPT score≥25, HBR patients incurred an increased risk not only of bleeding but also of multiple ischemic events. There was no significant interaction between HBR status and clinical outcomes associated with ESC/EACTS-HIR criteria (all Pinteraction>0.05).
Conclusions
ESC/EACTS-high ischemic risk and high bleeding risk (PRECISE-DAPT score≥25) were both significant predictors for ischemic clinical events in patients undergoing PCI. However, ESC/EACTS-high ischemic risk had a greater and more prolonged effect on outcomes than high bleeding risk (PRECISE-DAPT score ≥ 25).