Abstract 2612: Derived Fibrinogen Versus Brain Natriuretic Peptide and C-Reactive Protein as a Predictor of Events After Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Terry R Ketch ◽  
Samuel J Turner ◽  
Matthew T Sacrinty ◽  
Kevin C Lingle ◽  
Robert J Applegate ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Stent Placement ◽  
Proportional Hazards ◽  
Thrombus Formation ◽  
Smoking Status ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Cardiac Events ◽  
Coronary Events

Multiple biomarkers have been studied to assess risk for future coronary events. Fibrinogen is involved in platelet aggregation, thrombus formation, and is a marker of inflammation. Furthermore, prothrombin time-derived fibrinogen levels are widely available with routine coagulation assays. We retrospectively evaluated admission derived fibrinogen, BNP and CRP levels as well as baseline clinical and procedural characteristics of 475 consecutive patients admitted with acute myocardial infarction who subsequently underwent stent placement. Major adverse cardiac event (MACE) outcomes data were collected to two years after index admission. Higher quartiles of admission fibrinogen levels were associated with increased hazard of death from any cause (log-rank p-value <0.001), non-fatal myocardial infarction (log-rank p-value <0.001), and any MACE (log-rank p-value = 0.004) at two years. In a Cox proportional hazards multivariate model including the covariates age (10 years), heart failure class, smoking status, diabetes, hypertension, cerebrovascular disease, history of renal failure, previous PCI and/or CABG, multivessel coronary disease, BNP and CRP, increased admission derived fibrinogen remained a significant predictor of increased hazard of MACE at two years [HR 2.22 (1.03– 4.77)]. In the same model, BNP [HR 0.95 (0.82–1.08)] and CRP [HR 1.22 (1.01–1.47)] were less robust prognosticators. In patients admitted with an acute myocardial infarction who undergo PCI with stent placement, admission derived fibrinogen levels, a widely available analyte, are more strongly predictive of future major adverse cardiac events than BNP and CRP.

Vitality and recurrent event risk in acute myocardial infarction survivors

2009 ◽  
Vol 16 (4) ◽  
pp. 499-505 ◽  
Author(s):  
Brent A. Williams ◽  
Joan M. Dorn ◽  
Richard P. Donahue ◽  
Kathleen M. Hovey ◽  
Lisa B. Rafalson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Disease Risk ◽  
Short Form ◽  
Cardiovascular Disease Risk ◽  
Cox Proportional Hazards ◽  
Recurrent Event ◽  
Cardiac Events ◽  
Increased Risk

Background Low vitality, characterized by fatigue and lack of energy, is common among survivors of acute myocardial infarction (AMI) and has been shown to be associated with increased risk of primary and secondary cardiac events. The goal of this study was to determine whether an association between vitality and recurrent cardiac events (nonfatal MI, cardiac death) among acute MI survivors persists after controlling for possible physiological and psychological confounders. Design and methods Incident AMI survivors ( n = 1328) from Erie and Niagara (New York) county hospitals were enrolled and followed up to 9 years. Vitality was measured by the Short Form-36 on a 0–100 scale approximately 4 months post-AMI. Cox proportional hazards models were developed to assess the vitality-recurrent event association controlling for traditional cardiovascular disease risk factors, index MI severity, and psychological correlates of vitality. Results Low-vitality individuals at baseline were more likely females, of higher BMI, smoking, diabetic, less physically active, and to have worse depression scores. Vitality was not strongly associated with MI severity markers. Lower vitality scores were associated with increased risk of recurrent cardiac events: adjusted hazard ratios (95% CI) for vitality scores 51–79, 21–50, and ≤ 20 (compared with ≥ 80) were 1.2 (0.8, 1.8), 1.4 (0.9, 2.2), and 2.9 (1.5, 5.4), respectively ( Ptrend = 0.005). Conclusion Low vitality was associated with increased risk of recurrent cardiac events among AMI survivors after controlling for physiological and psychological confounders. Mechanistic links with vitality should be sought as interventional targets.

Association of Stress hyperglycemia and adverse cardiac events in acute myocardial infarction – A cohort study

2021 ◽  
Vol 22 ◽  
Author(s):  
Annu Rajpurohit ◽  
Bharat Sejoo ◽  
Rajendra Bhati ◽  
Prakash Keswani ◽  
Shrikant Sharma ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Blood Glucose ◽  
Clinical Outcomes ◽  
P Value ◽  
Cardiac Events ◽  
Stress Hyperglycemia ◽  
Adverse Cardiac Events ◽  
Hba1c Levels

Background: Stress hyperglycemia is a common phenomenon in patients presenting with acute myocardial infarction (MI). We aim to evaluate the association of stress hyperglycemia at the time of hospital presentation and adverse cardiac events in myocardial infarction during the course of hospital stay. Methods: Subjects with age ≥18 years with acute MI were recruited on hospital admission and categorized based on admission blood glucose (<180 and ≥180 mg/dl, 50 patients in each group). Both groups were compared for clinical outcomes, adverse cardiac events and mortality. We also compared the adverse cardiac outcomes based on HbA1c levels (<6% and ≥6%). Results: Patients with high blood glucose on admission (stress hyperglycemia) had significant increased incidences of severe heart failure (Killip class 3 and 4), arrythmias, cardiogenic shock and mortality (p value = 0.001, 0.004, 0.044, and 0.008 respectively). There was no significant association between adverse cardiac events and HbA1c levels (heart failure 18.8% vs. 25%, p value = 0.609 and mortality 16.7% vs. 17.3%, p value = 0.856). Conclusions: Stress hyperglycemia is significantly associated with adverse clinical outcomes in patients with MI irrespective of previous diabetic history or glycemic control. Clinicians should be vigilant for admission blood glucose while treating MI patients.

scholarly journals Smokeless tobacco, snus, at admission for percutaneous coronary intervention and future risk for cardiac events

Open Heart ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. e001109
Author(s):  
Ole Frobert ◽  
Christian Reitan ◽  
Dorothy K Hatsukami ◽  
John Pernow ◽  
Elmir Omerovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Percutaneous Coronary Intervention ◽  
Smokeless Tobacco ◽  
Proportional Hazards ◽  
Coronary Intervention ◽  
Cox Proportional Hazards ◽  
P Value ◽  
Cardiac Events ◽  
Percutaneous Coronary ◽  
All Cause Mortality

ObjectiveTo assess the risk of future death and cardiac events following percutaneous coronary intervention (PCI) in patients using smokeless tobacco, snus, compared with patients not using snus at admission for a first PCI.MethodsThe Swedish Coronary Angiography and Angioplasty Registry is a prospective registry on coronary diagnostic procedures and interventions. A total of 74 958 patients admitted for a first PCI were enrolled between 2009 and 2018, 6790 snus users and 68 168 not using snus. We used Cox proportional hazards regression for statistical modelling on imputed datasets as well as complete-case datasets.ResultsPatients using snus were younger (mean (SD) age 61.0 (±10.2) years) than patients not using snus (67.6 (±11.1), p<0.001) and more often male (95.4% vs 67.4%, p<0.001). After multivariable adjustment, snus use was not associated with the primary composite outcome of all-cause mortality, new coronary revascularisation or new hospitalisation for heart failure at 1 year (HR 0.98, 95% CI 0.91 to 1.05). In patients using snus at baseline who underwent a second PCI (n=1443), the duration from the index intervention was shorter for subjects who continued using snus (n=921, 63.8%) compared with subjects who had stopped (mean number of days 285 vs 406, p value=0.001).ConclusionsSnus use at admission for a first PCI was not associated with a higher occurrence of all-cause mortality, new revascularisation or heart failure hospitalisation. Discontinuing snus after a first PCI was associated with a significantly longer duration to a subsequent PCI.

scholarly journals Association of Acidemia With Short-Term Mortality of Acute Myocardial Infarction: A Retrospective Study Base on MIMIC-III Database

2020 ◽  
Vol 26 ◽  
pp. 107602962095083
Author(s):  
Tang Zhang ◽  
Yao-Zong Guan ◽  
Hao Liu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Short Term ◽  
Hazards Model ◽  
Short Term Mortality ◽  
Mimic Iii

Acute myocardial infarction (AMI) is a leading cause of death and not a few of these patients are combined with acidemia. This study aimed to detect the association of acidemia with short-term mortality of AMI patients. A total of 972 AMI patients were selected from the Medical Information Mart for Intensive Care (MIMIC) III database for analysis. Propensity-score matching (PSM) was used to reduce the imbalance. Kaplan-Meier survival analysis was used to compare the mortality, and Cox-proportional hazards model was used to detect related factors associated with mortality. After PSM, a total of 345 non-acidemia patients and 345 matched acidemia patients were included. The non-acidemia patients had a significantly lower 30-day mortality (20.0% vs. 28.7%) and lower 90-day mortality (24.9% vs. 31.9%) than the acidemia patients ( P < 0.001 for all). The severe-acidemia patients (PH < 7.25) had the highest 30-day mortality (52.6%) and 90-day mortality (53.9%) than non-acidemia patients and mild-acidemia (7.25 ≤ PH < 7.35) patients ( P < 0.001). In Cox-proportional hazards model, acidemia was associated with improved 30-day mortality (HR = 1.518; 95%CI = 1.110-2.076, P = 0.009) and 90-day mortality (HR = 1.378; 95%CI = 1.034 -1.837, P = 0.029). These results suggest that severe acidemia is associated with improved 30-day mortality and 90-day mortality of AMI patients.

Factor XIII-A dynamics in acute myocardial infarction: a novel prognostic biomarker?

2015 ◽  
Vol 114 (07) ◽  
pp. 123-132 ◽  
Author(s):  
Giulia Zeri ◽  
Elisa Orioli ◽  
Rosella Mari ◽  
Stefano Moratelli ◽  
Marco Vigliano ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Factor Xiii ◽  
Thrombus Formation ◽  
Early Death ◽  
Prognostic Indicators ◽  
Cardiac Events ◽  
Acute Mi ◽  
The Individual

SummaryAfter acute myocardial infarction (MI) the damaged heart has to be repaired. Factor XIII (FXIII) is considered a key molecule in promoting heart healing. FXIII deficiency was associated to cardiac rupture and anomalous remodelling in MI. During MI, FXIII contributes firstly to the intracoronary thrombus formation and shortly after to heal the myocardial lesion. To quantify the real contribution of FXIII in this process, and to explore its possible prognostic role, we monitored the FXIII-A subunit levels in 350 acute MI patients during the first six days (d0-d5) plus a control at 30–60 days (d30). A one-year follow-up was performed for all the patients. A transient drop in the FXIII-A mean level was noted in the whole cohort of patients (FXIII-Ad0 99.48 ± 30.5 vs FXIII-Ad5 76.51 ± 27.02; p< 0.0001). Interestingly, those who developed post-MI heart failure showed the highest drop (FXIII-Ad5 52.1 ± 25.2) and they already presented with low levels at recruitment. Similarly, those who died showed the same FXIII-A dynamic (FXIII-Ad5 54.0 ± 22.5). Conversely, patients who remained free of major adverse cardiac events, had lower consuming (FXIII-Ad0 103.6 ± 29.1 vs FXIII-Ad5 84.4 ± 24.5; p< 0.0001). Interestingly, the FXIII-A drop was independent from the amount of injury assessed by TnT and CKMB levels. The survival analysis ascribed an increased probability of early death or heart failure inversely related to FXIII-A quartiles (FXIII-A25th< 59.5 %; hazard ratio 4.25; 2.2–5.1; p< 0.0001). Different FXIII-A dynamics and levels could be utilised as early prognostic indicators during acute MI, revealing the individual potential to heal and suggesting tailored treatments to avoid heart failure or its extreme consequence.Note: This paper was presented in part at the 14th Congress of the International Society on Thrombosis and Haemostasis, Amsterdam, Netherlands, June 29 – July 24, 2013.

scholarly journals Circulating Matrix Metalloproteinase-28 Levels Are Related to GRACE Scores and Short-Term Outcomes in Patients with Acute Myocardial Infarction

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ke Zhou ◽  
Yuanmin Li ◽  
Yawei Xu ◽  
Rong Guo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Matrix Metalloproteinase ◽  
Cardiovascular Events ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Events ◽  
Short Term ◽  
St Elevation ◽  
Coronary Events ◽  
Grace Score

Objective. To investigate the relationship between the level of matrix metalloproteinase-28 (MMP-28) in patients with acute myocardial infarction (AMI) and the global registry of acute coronary events (GRACE) scores as well as their short-term prognosis. Methods. Two hundred eleven patients with AMI were enrolled, and their basic clinical characteristics were collected for determining the GRACE score. We measured the plasma levels of MMP-28 and other biomarkers in the study population. The association of MMP-28 levels with cardiac events and cardiac deaths occurring within 30 days of discharge was evaluated with multivariable Cox proportional hazard models. Results. The MMP-28 levels were significantly higher in patients with acute ST-elevation myocardial infarction (STEMI) than in patients with non-ST-elevation myocardial infarction (NSTEMI) (P<0.01). Correlation analysis showed that the level of MMP-28 was positively correlated with the GRACE score in patients with AMI (R2=0.366, P<0.05). Cox multivariate regression results showed that MMP-28 was associated with cardiovascular events during the hospitalization and 30 days after discharge (P<0.01). In addition, Kaplan–Meier analysis showed that cardiac events and deaths were significantly higher in patients with MMP-28≥1.21 ng/mL (all P<0.01). Conclusion. There is a correlation between the plasma MMP-28 level and GRACE score in patients with AMI. MMP-28 is also associated with cardiovascular events and cardiovascular deaths during the hospitalization of patients and within 30 days of discharge.

scholarly journals Prognostic Role of High Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyuan Zhang ◽  
Shanjie Wang ◽  
Shaohong Fang ◽  
Bo Yu
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
High Sensitivity ◽  
Cox Proportional Hazards ◽  
Post Discharge ◽  
Reactive Protein ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Hs Crp

Background: High sensitivity CRP (hs-CRP) has attracted intense interest in risk assessment. We aimed to explore its prognostic value in patients with acute myocardial infarction (AMI).Methods and Results: We enrolled 4,504 consecutive AMI patients in this prospective cohort study. The associations between hs-CRP levels with the incidence of in-hospital HF was evaluated by logistic regression analysis. The association between hs-CRP levels and the cumulative incidence of HF after hospitalization were evaluated by Fine-Gray proportional sub-distribution hazards models, accounting for death without HF as competing risk. Cox proportional hazards regression models were constructed to estimate the association between hs-CRP levels and the risk of all-cause mortality. Over a median follow-up of 1 year, 1,112 (24.7%) patients developed in-hospital HF, 571 (18.9%) patients developed HF post-discharge and 262 (8.2%) patients died. In the fully adjusted model, the risk of in-hospital heart failure (HF) [95% confidence intervals (CI)] among those patients with hs-CRP values in quartile 3 (Q3) and Q4 were 1.36 (1.05–1.77) and 1.41 (1.07–1.85) times as high as the risk among patients in Q1 (p trend &lt; 0.001). Patients with hs-CRP values in Q3 and Q4 had 1.33 (1.00–1.76) and 1.80 times (1.37–2.36) as high as the risk of HF post-discharge compared with patients in Q1 respectively (p trend &lt; 0.001). Patients with hs-CRP values in Q3 and Q4 had 1.74 (1.08–2.82) and 2.42 times (1.52–3.87) as high as the risk of death compared with patients in Q1 respectively (p trend &lt; 0.001).Conclusions: Hs-CRP was found to be associated with the incidence of in-hospital HF, HF post-discharge and all-cause mortality in patients with AMI.

scholarly journals Correlation between Urinary Albumin to Creatinine Ratio and In-hospital Cardiac Events among Patients with Acute Myocardial Infarction

2016 ◽  
Vol 8 (2) ◽  
pp. 90-93
Author(s):  
Md Abdul Kader Akanda ◽  
Md Zulfikar Ali ◽  
Lima Asrin Sayami ◽  
Mohammad Anowar Hossain ◽  
Reaz Mahmud Huda ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Urinary Albumin ◽  
Categorical Variables ◽  
P Value ◽  
Creatinine Ratio ◽  
Cardiac Events ◽  
Spot Urine ◽  
Conduction Disorders ◽  
Traditional Risk Factors

Background: Urinary albumin to creatinine ratio (UACR) is an important predictor of major adverse cardiac events (MACE). However, limited data is available regarding its correlation with in-hospital MACE in patients with acute myocardial infarction (AMI). The aim of the current study was to find out the correlation between UACR and in-hospital MACE among patients with AMI.Methods: 651 AMI patients (mean age: 54.4 ± 12.6 years, male/female: 522/129, STEMI/NSTEMI: 438/213) admitted from November 2013 to December 2014 were enrolled in this observational study. The UACR was measured from spot urine samples collected on admission day. Data on patient’s demography, existence of traditional risk factors for cardiovascular diseases (CVD) and baseline clinical parameters were recorded on admission day. The patients were categorized into three groups - normoalbuminuria (UACR less than 30mg/gCr, n = 404), microalbuminuria (UACR between 30 to 299 mg/gCr, n = 215) and macroalbuminuria (UACR equal to or greater than 300 mg/ gCr, n = 32). For each enrolled patients, the incidences of specified in-hospital MACE (recurrent angina, acute heart failure, arrhythmia, atrio-ventricular conduction disorders, mechanical complications, cardiogenic shock and cardiac arrest) were recorded throughout the hospital staying period. The comparison of categorical variables between the groups was performed using the chisquare test. p < 0.05 was considered statistically significant.Results: The baseline characteristics (age, male gender, hypertension, hyperlipidemia, diabetes mellitus, family history of CVD, smoking) of three groups were statistically similar. Compared to normoalbuminuria group, the incidences of MACE were significantly higher in micro and macro albuminuria group (p-value: normo vs. micro 0.001 and normo vs. macro 0.006). However, the occurrences of MACE in microalbuminuria group were statistically similar to those of macroalbuminuria group (p-value: micro vs. macro 0.284).Conclusion: Urinary albumin to creatinine ratio, at a level of micro and macro albuminuria, was associated with greater incidence of in-hospital MACE compared to its normal level in patients with AMI.Cardiovasc. j. 2016; 8(2): 90-93

Abstract 172: Does SAMMPRIS Support Stenting Compared to Medical Therapy for Subpopulations of Patients with Intracranial Arterial Stenosis?

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Helmi L Lutsep ◽  
Michael J Lynn ◽  
George A Cotsonis ◽  
Colin P Derdeyn ◽  
Tanya N Turan ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Proportional Hazards ◽  
Smoking Status ◽  
Recurrent Stroke ◽  
Recent Change ◽  
Cox Proportional Hazards ◽  
Arterial Stenosis ◽  
P Value ◽  
Intracranial Arterial Stenosis ◽  
Baseline Factors

Objectives: To determine whether SAMMPRIS supported the use of stenting compared to medical therapy alone to prevent recurrent stroke in subpopulations of patients with symptomatic intracranial arterial stenosis. Methods: The primary outcome, 30-day stroke and death and later strokes in the territory of the qualifying artery, was compared in those with and without baseline factors in the two treatment arms, percutaneous transluminal angioplasty and stenting (PTAS) plus aggressive medical therapy (AMM) vs. AMM alone. Baseline factors included gender, age (<60 or ≥60 years), race (white or black), diabetes, hypertension, lipid disorder, smoking status, type of qualifying event (QE) (TIA, non-penetrator stroke or penetrator stroke), QE hypoperfusion symptoms (related to either change in position, exertion or recent change in antihypertensive), use of antithrombotic or proton pump inhibitor at baseline, days to enrollment (≤7 or >7), old infarcts in the same territory, percent stenosis (<80% or ≥80%), other artery stenosis and location of the symptomatic artery (internal carotid, middle cerebral, vertebral or basilar; and anterior or posterior). The subgroup analyses were conducted by fitting a Cox proportional hazards regression model that included treatment, treatment by time, the factor, and the treatment by factor interaction (p-value for which is reported). Results: A total of 451 patients were enrolled, 227 randomized to AMM and 224 to PTAS. Of all variables evaluated, the observed 2-year event rates were higher with PTAS than with AMM in the vast majority and the interaction with treatment was not statistically significant for any of the factors (Table). Conclusions: The SAMMPRIS results do not support the use of PTAS compared to medical treatment in any examined subpopulation of patients with symptomatic intracranial stenosis, including those with QE hypoperfusion symptoms.

Outcomes in patients treated with ticagrelor versus clopidogrel after acute myocardial infarction stratified by renal function

Heart ◽  
2018 ◽  
Vol 104 (19) ◽  
pp. 1575-1582 ◽  
Author(s):  
Robert Edfors ◽  
Anders Sahlén ◽  
Karolina Szummer ◽  
Henrik Renlund ◽  
Marie Evans ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Proportional Hazards ◽  
Composite Endpoint ◽  
Bleeding Risk ◽  
Cox Proportional Hazards ◽  
Secondary Outcome ◽  
Composite Outcome ◽  
Bleeding Events ◽  
Cox Proportional Hazards Models

ObjectivesWe aimed to analyse outcomes of ticagrelor and clopidogrel stratified by estimated glomerular filtration rate (eGFR) in a large unselected cohort of patients with acute myocardial infarction (MI).MethodsWe used follow-up data in MI survivors discharged on ticagrelor or clopidogrel enrolled in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies registry. The association between ticagrelor versus clopidogrel and the primary composite outcome of death, MI or stroke and the secondary outcome rehospitalisation with bleeding diagnosis at 1 year, was studied using adjusted Cox proportional hazards models, stratifying after eGFR levels.ResultsIn total, 45 206 patients with MI discharged on clopidogrel (n=33 472) or ticagrelor (n=11 734) were included. The unadjusted 1-year event rate for the composite endpoint of death, MI or stroke was 7.0%, 18.0% and 48.0% for ticagrelor treatment and 11.0%, 33.0% and 64.0% for clopidogrel treatment in patients with eGFR>60 (n=33 668), eGFR30–60 (n=9803) and eGFR<30 (n=1735), respectively. After adjustment, ticagrelor as compared with clopidogrel was associated with a lower 1-year risk of the composite outcome (eGFR>60: HR 0.87, 95% CI 0.76 to 99, eGFR30–60: 0.82 (0.70 to 0.97), eGFR<30: 0.95 (0.69 to 1.29), P for interaction=0.55) and a higher risk of bleeding (eGFR>60: HR 1.10, 95% CI 0.90 to 1.35, eGFR30–60: 1.13 (0.84 to 1.51), eGFR<30: 1.79 (1.00 to 3.21), P for interaction=0.30) across the eGFR strata.ConclusionsTreatment with ticagrelor as compared with clopidogrel in patients with MI was associated with lower risk for the composite of death, MI or stroke and a higher bleeding risk across all strata of eGFR. Of caution, bleeding events were more abundant in patients with eGFR<30.

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