"High risk group of bleeding after coronary intervention, 3.7 times higher risk of death"
Aug 29, 2024
The results of a large-scale study analyzing the long-term prognosis of patients at high risk of bleeding after coronary intervention have been published.
They had more long-term side effects than other patients, and the risk of death was 3.7 times higher. In order to improve the prognosis of these high-risk bleeding groups, patient-specific treatment strategies are likely to be needed.
A research team led by Kim Hyo-soo, Park Kyung-woo, and Kang Ji-hoon (clinical instructor Yoon Joon-pil) of the Department of Circulatory Medicine at Seoul National University Hospital announced the results of a study that analyzed clinical characteristics and long-term prognosis by selecting high-risk groups for bleeding based on data from the Health Insurance Corporation of 325,000 patients who underwent coronary intervention from 2009 to 2018.
Acute coronary syndrome is a fatal disease that causes angina and myocardial infarction. For treatment, coronary intervention is performed to widen the narrowed coronary artery. After the procedure, taking antiplatelet drugs is essential to prevent recurrence, and hemorrhagic side effects can occur if a person with an underlying disease takes the drug for a long time.
In 2019, an international research consortium published the concept and criteria of 'high risk of bleeding' to select patients vulnerable to hemorrhagic side effects of antiplatelet drugs after coronary intervention.
The high-risk group for bleeding refers to patients with >'collateral features, such as long-term antiplatelet drug use, severe-end renal disease, severe anemia, cirrhosis, cancer, and brain bleeding, etc. '1', or 'collateral features 2', such as aged 75 or older, moderate kidney disease, mild anemia, and long-term use of steroids or nonsteroidal anti-inflammatory drugs.
However, studies verifying the concept and criteria of high-risk bleeding groups by analyzing scale, clinical characteristics, and long-term prognosis in large patient groups were insufficient. According to the research team's analysis of 325,000 domestic patients who underwent coronary intervention procedures, 1 in 5 was at high risk of bleeding.
As a result of a 10-year follow-up of the prognosis of all patients, the high-risk group of bleeding had a 3.12 and 2.5 times higher risk of hemorrhagic and ischemic events (myocardial infarction, ischemic stroke, etc.) than the rest of the patient group, respectively. In addition, the risk of death from all causes was 3.73 times higher. In other words, the high risk group of bleeding had a higher risk of clinical side effects and death in the long term after coronary intervention.
Additionally, the research team analyzed the main and incidental characteristics, which are the criteria for classification of high-risk bleeding groups. The main characteristics were severe anemia (24.2%), long-term antiplatelet medication (22.2%), chronic bleeding (11.0%), and severe-end-stage renal disease (9.1%). The incidental characteristics included aged 75 or older (50.5%) and mild anemia (42.1%). In particular, the annual average incidence of hemorrhagic events within one year after coronary intervention was 5.5% for one major characteristic and 2.9% for one incidental characteristic.
Professor Kyung-Woo Park of the Department of Circulatory Medicine confirmed that 20% of coronary intervention patients are at high risk of bleeding with a poor long-term prognosis"In order to improve their survival rates, they need a customized drug treatment strategy that is carefully controlled for comorbidities, shortening the duration of taking antiplatelet drugs, or lowering the dose. "
Meanwhile, the results of this study were published in the recent issue of 'European Heart Journal (IF;37.6)'.
They had more long-term side effects than other patients, and the risk of death was 3.7 times higher. In order to improve the prognosis of these high-risk bleeding groups, patient-specific treatment strategies are likely to be needed.
A research team led by Kim Hyo-soo, Park Kyung-woo, and Kang Ji-hoon (clinical instructor Yoon Joon-pil) of the Department of Circulatory Medicine at Seoul National University Hospital announced the results of a study that analyzed clinical characteristics and long-term prognosis by selecting high-risk groups for bleeding based on data from the Health Insurance Corporation of 325,000 patients who underwent coronary intervention from 2009 to 2018.
Acute coronary syndrome is a fatal disease that causes angina and myocardial infarction. For treatment, coronary intervention is performed to widen the narrowed coronary artery. After the procedure, taking antiplatelet drugs is essential to prevent recurrence, and hemorrhagic side effects can occur if a person with an underlying disease takes the drug for a long time.
In 2019, an international research consortium published the concept and criteria of 'high risk of bleeding' to select patients vulnerable to hemorrhagic side effects of antiplatelet drugs after coronary intervention.
The high-risk group for bleeding refers to patients with >'collateral features, such as long-term antiplatelet drug use, severe-end renal disease, severe anemia, cirrhosis, cancer, and brain bleeding, etc. '1', or 'collateral features 2', such as aged 75 or older, moderate kidney disease, mild anemia, and long-term use of steroids or nonsteroidal anti-inflammatory drugs.
However, studies verifying the concept and criteria of high-risk bleeding groups by analyzing scale, clinical characteristics, and long-term prognosis in large patient groups were insufficient. According to the research team's analysis of 325,000 domestic patients who underwent coronary intervention procedures, 1 in 5 was at high risk of bleeding.
As a result of a 10-year follow-up of the prognosis of all patients, the high-risk group of bleeding had a 3.12 and 2.5 times higher risk of hemorrhagic and ischemic events (myocardial infarction, ischemic stroke, etc.) than the rest of the patient group, respectively. In addition, the risk of death from all causes was 3.73 times higher. In other words, the high risk group of bleeding had a higher risk of clinical side effects and death in the long term after coronary intervention.
Additionally, the research team analyzed the main and incidental characteristics, which are the criteria for classification of high-risk bleeding groups. The main characteristics were severe anemia (24.2%), long-term antiplatelet medication (22.2%), chronic bleeding (11.0%), and severe-end-stage renal disease (9.1%). The incidental characteristics included aged 75 or older (50.5%) and mild anemia (42.1%). In particular, the annual average incidence of hemorrhagic events within one year after coronary intervention was 5.5% for one major characteristic and 2.9% for one incidental characteristic.
Professor Kyung-Woo Park of the Department of Circulatory Medicine confirmed that 20% of coronary intervention patients are at high risk of bleeding with a poor long-term prognosis"In order to improve their survival rates, they need a customized drug treatment strategy that is carefully controlled for comorbidities, shortening the duration of taking antiplatelet drugs, or lowering the dose. "
Meanwhile, the results of this study were published in the recent issue of 'European Heart Journal (IF;37.6)'.
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