Journal article
Comparative influence of bleeding and ischemic risk factors on diabetic patients undergoing percutaneous coronary intervention with everolimus-eluting stents.
- Goel R The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
- Cao D The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
- Chandiramani R The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
- Roumeliotis A The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
- Blum M The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
- Bhatt DL Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts.
- Angiolillo DJ College of Medicine-Jacksonville, University of Florida, Jacksonville, Florida.
- Ge J Zhongshan Hospital, Fudan University, Shanghai, China.
- Seth A Fortis Escorts Heart Institute, New Delhi, India.
- Saito S Shonan Kamakura General Hospital, Kamakura, Japan.
- Krucoff M Duke University Medical Center, Durham, North Carolina.
- Kozuma K Division of Cardiology, Teikyo University, Tokyo, Japan.
- Makkar RM Cedars-Sinai Medical Center, Los Angeles, California.
- Bangalore S Department of Cardiovascular Diseases, New York University-Langone Medical Center, New York City, New York.
- Wang L Abbott Vascular, Santa Clara, California.
- Koo K Abbott Vascular, Santa Clara, California.
- Neumann FJ Department of Cardiology and Angiology II, University Heart Center Freiburg, Bad Krozingen, Germany.
- Hermiller J Division of Cardiovascular Medicine, St Vincent Heart Center of Indiana, Indianapolis, Indiana.
- Stefanini G Department of Biomedical Sciences, Humanitas University, Milan, Italy.
- Valgimigli M Department of Cardiology, Bern University Hospital, Bern, Switzerland.
- Mehran R The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York.
- 2020-10-10
Published in:
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. - 2020
English
OBJECTIVE
To investigate the impact of ischemic and bleeding risk factors on long-term clinical outcomes of patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents.
BACKGROUND
Second-generation drug-eluting stents have substantially improved outcomes after PCI in the general population; however, DM patients continue to experience high rates of ischemic and bleeding complications.
METHODS
DM patients from the pooled XIENCE V registry were divided into high or low bleeding and ischemic risk groups (HBR, LBR, HIR, and LIR) based on established bleeding (age ≥ 75 years; chronic kidney disease; anemia; prior stroke; oral anticoagulation; thrombocytopenia; prior major bleeding) and ischemic (acute coronary syndrome; prior myocardial infarction [MI]; ≥3 stents implanted; ≥3 vessels treated; ≥3 lesions treated; stent length > 60 mm; bifurcation treated with ≥2 stents; chronic total occlusion) risk factors. The primary outcomes were major adverse cardiac events (MACE; cardiac death, MI, or stent thrombosis) and major bleeding at 4-year follow-up.
RESULTS
A total of 3,704 DM patients were divided into four groups (21.5% LBR/LIR; 39.0% LBR/HIR; 15.6% HBR/LIR; 23.9% HBR/HIR). Compared with LBR/LIR patients, those at HBR/HIR and HBR/LIR had a significantly higher risk of MACE (HR (95% CI) 2.7 (1.9-3.9) and 2.2 (1.5-3.2), respectively) and major bleeding (2.7 (1.6-4.8) and 2.6 (1.4-4.7), respectively), while LBR/HIR patients did not.
CONCLUSIONS
Among DM patients undergoing PCI, presence of bleeding risk factors was associated with a higher risk of both ischemic and bleeding events, whereas commonly used features of ischemic risk did not impact long-term clinical outcomes.
To investigate the impact of ischemic and bleeding risk factors on long-term clinical outcomes of patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents.
BACKGROUND
Second-generation drug-eluting stents have substantially improved outcomes after PCI in the general population; however, DM patients continue to experience high rates of ischemic and bleeding complications.
METHODS
DM patients from the pooled XIENCE V registry were divided into high or low bleeding and ischemic risk groups (HBR, LBR, HIR, and LIR) based on established bleeding (age ≥ 75 years; chronic kidney disease; anemia; prior stroke; oral anticoagulation; thrombocytopenia; prior major bleeding) and ischemic (acute coronary syndrome; prior myocardial infarction [MI]; ≥3 stents implanted; ≥3 vessels treated; ≥3 lesions treated; stent length > 60 mm; bifurcation treated with ≥2 stents; chronic total occlusion) risk factors. The primary outcomes were major adverse cardiac events (MACE; cardiac death, MI, or stent thrombosis) and major bleeding at 4-year follow-up.
RESULTS
A total of 3,704 DM patients were divided into four groups (21.5% LBR/LIR; 39.0% LBR/HIR; 15.6% HBR/LIR; 23.9% HBR/HIR). Compared with LBR/LIR patients, those at HBR/HIR and HBR/LIR had a significantly higher risk of MACE (HR (95% CI) 2.7 (1.9-3.9) and 2.2 (1.5-3.2), respectively) and major bleeding (2.7 (1.6-4.8) and 2.6 (1.4-4.7), respectively), while LBR/HIR patients did not.
CONCLUSIONS
Among DM patients undergoing PCI, presence of bleeding risk factors was associated with a higher risk of both ischemic and bleeding events, whereas commonly used features of ischemic risk did not impact long-term clinical outcomes.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1002/ccd.29314
- PMID 33038061
- Persistent URL
- https://sonar.ch/global/documents/84
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