No Evidence for an Association Between Renal Function and Serious Bleeding Events in Patients Treated With Coumarins: A Population-Based Study

2017 ◽  
Vol 52 (3) ◽  
pp. 221-234
Author(s):  
Eline Houben ◽  
Elisabeth Smits ◽  
Jetty A. Overbeek ◽  
Fernie J. A. Penning-van Beest ◽  
Ron M. C. Herings ◽  
...  
Keyword(s):  
Renal Function ◽  
Index Date ◽  
Anticoagulation Therapy ◽  
Bleeding Event ◽  
Population Based ◽  
Geographic Region ◽  
Bleeding Events ◽  
Significant Difference ◽  
Using Data ◽  
Estimated Glomerular Filtration Rates

Background: Although anticoagulation therapy is closely monitored in the Netherlands, coumarin-induced serious bleeding events are still observed. Current literature suggests that renal impairment may contribute to this. Objective: To explore the association between renal function and bleeding events during coumarin treatment. Methods: A nested case-control study was conducted using data from the PHARMO Database Network. Patients hospitalized for a bleeding event during coumarin treatment were selected as cases and matched on sex, birth year, and geographic region to up to 2 controls using coumarins without hospitalization for bleeding. All values of estimated glomerular filtration rates (eGFRs) were selected in the year before index date (case hospitalization date) and compared between cases and controls using logistic regression analyses. Results: In total, 2224 cases were matched to 4398 controls (61% male; mean ± SD age 75 ± 11 and 78 ± 11 years among cases and controls, respectively). Availability of eGFR values was higher among cases compared with controls (mean ± SD eGFR values 4.5 ± 7.1 vs 3.2 ± 5.5), reflected in the significantly shorter time since last eGFR value (at index date, mean ± SD = 2.7 ± 3.0 vs 3.8 ± 3.1 months; odds ratio [OR] = 0.91, 95%CI = 0.89-0.92). No statistically significant difference was found for the mean eGFR value in the year before index date (mean ± SD 65.7 ± 22.8 vs 64.6 ± 20.9 mL/min/1.73 m2; OR per 10 units [95%CI] = 0.99 [0.96-1.02]). Conclusions: No association between renal function and serious bleeding events during coumarin treatment was observed.

scholarly journals Impact of antithrombotic therapy in the prognosis of atrial fibrillation patients with advanced chronic kidney disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.M Andreu Cayuelas ◽  
S Raposeiras-Roubin ◽  
E Fortuny Frau ◽  
A Garcia Del Egido ◽  
J Seller-Moya ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Antithrombotic Therapy ◽  
Anticoagulation Therapy ◽  
Bleeding Event ◽  
Funding Source ◽  
Newly Diagnosed ◽  
Bleeding Events ◽  
Cox Regression Analysis

Abstract Introduction Chronic kidney disease (CKD) is associated with an elevated thromboembolic and bleeding risk in atrial fibrillation (AF) patients, so the decision of antithrombotic therapy is a challenge. Purpose To analyze mortality, embolic and bleeding events in patients with advanced CKD and AF. Methods Multicentric retrospective registry on patients with AF and advanced CKD (CKD-EPI <30 mL/min/1.73 m2). For death, multivariable Cox regression analysis was developed. For embolic and bleeding events, competing-risks regression based on Fine and Gray's proportional subhazards model was performed, being death the competing event Results We analysed 405 patients with advanced CKD and newly diagnosed AF. 57 patients were not treated with antithrombotic therapy (14.1%), 80 only with antiplatelet/s (19.8%), 211 only with anticoagulation (52.1%), and 57 with anticoagulant plus antiplatelet/s (14.1%). During a follow-up of 4.6±2.5 years, 205 died (50.6%), 34 had embolic events (8.4%) and 85 had bleeding outcomes (21.0%). Bleeding event rate was significantly lower in patients without antithrombotic therapy (Figure). After multivariate analysis, anticoagulant treatment was associated with higher bleeding rates, without differences in mortality or embolic events (Table). Conclusion Anticoagulation therapy was associated with a significant increase in bleeding events in patients with advanced CKD and newly diagnosed AF. None of the antithrombotic therapy regimens resulted in lower embolic events rate neither benefit in mortality. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): This study was supported by an unconditional grant from BMS-Pfizer

scholarly journals No Evidence For An Association Between Renal Function And Bleeding Events In Patients On Coumarin Therapy: A Population-Based Study

2017 ◽  
Vol 20 (9) ◽  
pp. A601
Author(s):  
E Houben ◽  
E Smits ◽  
JA Overbeek ◽  
RM Herings ◽  
MP Van Herk-Sukel ◽  
...  
Keyword(s):  
Renal Function ◽  
Population Based ◽  
Bleeding Events ◽  
Population Based Study

P1898Prevalence and risk of DOACs inappropriate dosing in atrial fibrillation. An analysis of the Swiss-AF and BEAT-AF registries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Montrasio ◽  
M Coslovsky ◽  
A Wiencierz ◽  
C Baumgartner ◽  
N Rodondi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Renal Function ◽  
Clinical Outcomes ◽  
Antiplatelet Therapy ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Bleeding Event ◽  
Bleeding Events ◽  
Off Label ◽  
Kaplan Meier

Abstract Background Direct oral anticoagulants (DOACs) have a similar efficacy in terms of stroke and mortality reduction as compared to Vitamin K-Antagonists (VKAs) and improved safety with regards to intracranial haemorrhage in patients with non-valvular atrial fibrillation (AF). Dose of DOACs needs to be adjusted according to age, weight, renal function and concomitant medication. Yet, off-label dosages have been reported in 11 - 45% of patients (on average 20%). Purpose To assess the prevalence of inappropriate DOAC-dosing according to the official prescribing information in two large prospective Swiss AF cohorts (Swiss-AF and BEAT-AF) and to evaluate its correlation with adverse clinical outcomes. Methods All 3267 patients taking oral anticoagulants were stratified at baseline as receiving DOACs (adequately dosed, under- or overdosed) or VKAs. Appropriateness of DOAC dosing was assessed based on age (≥80 years), weight (≤60kg) and renal function (serum creatinine ≥133μmol/l [apixaban]; creatinine clearence ≤50ml/min [all other DOACs]). Clinical outcomes were collected during a median follow-up of 2.96 years. Major adverse clinical events (MACE) consisted of a combination of myocardial infarction, cardiac death, ischemic stroke and systemic embolism. Safety was assessed by occurrence of any bleeding event. Results 1902 patients (58%) were on VKAs and 1365 on DOACs (42%). In the DOAC group, 1149 patients received a dose consistent with drug labelling (84%), 133 (10%) received an inappropriately high and 83 (6%) an inappropriately low dose. Overdosed patients were older than those adequately treated and more likely female, had a lower BMI and a higher CHA2DS2-VASc score (4 vs. 3 points) (p<0.001 for all). Underdosed patients were more likely to have concomitant antiplatelet therapy (p<0.001). Both off-label groups were more likely to have a history of coronary artery disease, heart failure and chronic kidney disease (p<0.001). Kaplan-Meier cumulative incidence rates for the first occurrence of MACE or bleedings are provided in Figure 1. Overdosed patients had an almost two-fold higher risk of bleeding (9.0 vs. 5.0 events per 100 patient-years compared to correctly dosed DOACs and to VKAs) and a higher rate of MACE (5.1 vs. 2.3 events per 100 patient years compared to correctly dosed DOACs and 5.1 vs. 3.4 compared to VKAs). Underdosing did not seem to be associated with a relevant increase in ischemic or bleeding events as compared to correctly dosed DOACs and VKAs (see Figure 1). Figure 1. Kaplan-Meier incidence curves Conclusion Inadequate DOACs dosing was found in 1 in 6 patients and correlated with a higher burden of comorbidities at baseline. Underdosing correlated with concomitant antiplatelet therapy. Overdosing was associated with adverse clinical outcome for ischemic and bleeding events.

Sociodemographic factors influencing Breslow thickness at diagnosis for patients with melanoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6552-6552
Author(s):  
K. B. Stitzenberg ◽  
N. E. Thomas ◽  
M. Berwick ◽  
H. Anton-Culver ◽  
U. J. Mujumdar ◽  
...  
Keyword(s):  
Rural Areas ◽  
Secondary Data ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Geographic Region ◽  
Breslow Thickness ◽  
Outcome Variable ◽  
Effective Measure ◽  
Significant Difference ◽  
Incident Cases

6552 Background: In previous work, we demonstrated that Breslow thickness at diagnosis is significantly related to distance to provider for patients with melanoma in North Carolina (NC). Expanding the study population to include patients in New Jersey (NJ) and southern California (CA), we hypothesize that distance to provider is an effective measure of access to melanoma care regardless of geographic region. Methods: An IRB-approved secondary data analysis was performed of all incident cases of invasive cutaneous melanoma in 2000 from 3 population-based ascertainment areas (CA, NC, NJ). Patients and providers were geocoded to street address; Euclidian distances between patients and providers were calculated. The outcome variable, Breslow thickness at diagnosis, was logged for analysis. Simple and multiple linear regression were used to test associations between Breslow thickness and multiple sociodemographic factors. Results: Of 1,408 eligible cases, 16% were excluded for missing Breslow data. Median Breslow thickness was 0.6 mm (range 0.01–30.0 mm). Median distance to provider was 7 miles (range 0–372 miles). There was no significant difference in Breslow between the 3 geographic regions. Males had on average 15.5% thicker tumors than females, p=0.009. Patients 51–80 years old had 15.3% thicker tumors than patients =50, p=0.015, and those >80 had 64.3% thicker tumors than patients =50, p<0.001. For all patients, Breslow thickness increased only 2% for each 10 mile increase in distance, p=0.047. However, when limited to patients from rural areas, each 10 mile increase in distance corresponded to an 8% increase in Breslow, p<0.001. Meanwhile, Breslow was not associated with any area-based measures of rurality or provider supply. Each 1% increase in poverty rate corresponded to a 1% increase in Breslow, p=0.036. Conclusion: Breslow thickness at diagnosis is strongly correlated with distance to provider, especially for patients from rural areas. Distance to provider is a better measure of access to melanoma care than area-based measures of rurality. No significant financial relationships to disclose.

scholarly journals Prevalence of sickle cell trait and its association to renal dysfunction among blood donors at university of medical sciences teaching hospital, Ondo, Nigeria

2021 ◽  
Vol 21 (3) ◽  
pp. 1237-1242
Author(s):  
Akinwumi Ayodeji Akinbodewa ◽  
Adeyemi Ogunleye ◽  
Oluseyi Ademola Adejumo
Keyword(s):  
Renal Function ◽  
Sickle Cell ◽  
Blood Donors ◽  
Sickle Cell Trait ◽  
P Value ◽  
Healthy Donors ◽  
Significant Difference ◽  
High Prevalence ◽  
The Mean ◽  
Estimated Glomerular Filtration Rates

Introduction: Prospective blood donors are routinely screened for blood borne infections but medical illnesses and haemo- globin genotype are overlooked despite a high prevalence of haemoglobin AS among Nigerian donors. Objective: To determine the prevalence of haemoglobin AS and its association to renal function, if any. Method: Apparently healthy donors were studied between February and December 2018. Their haemoglobin genotype and, estimated glomerular filtration rates were determined. Results: There were 96 males (94.1%) and 6 (5.9%) females with mean age of 26.7±4.5 years (range 19-44 years) and mean eGFR of 103.97±19.00ml/min/1.73m2. Eighty one (79.4%) and 21 (20.6%) subjects had haemoglobin AA and AS geno- types respectively. The mean eGFR for subjects with haemoglobin AA and AS were 105.2±18.6ml/min/1.73m2 and 99.9 ± 21.2ml/min/1.73m2 respectively (p value = 0.270). Eighty one (79.4%), 20 (19.6%) and 1 (1.0%) subjects had renal function at >90ml/min/1.73m2, 60-89ml/min/1.73m2 and 30-59ml/min/m2 respectively. There was no significant difference in the mean eGFR between subjects with haemoglobin AA and AS (mean difference 5.3, p = 0.265, 95%CI = -4.07 to 14.60). Conclusion: The prevalence of sickle cell trait among Nigerian blood donors is high. There is no significant difference in the renal function status of blood donors with SCT and normal haemoglobin genotype. Keywords: Haemoglobin genotype; sickle cell trait; renal function; blood donor; Nigeria.

Anticoagulation Changes Following Major and Clinically Relevant Nonmajor Bleeding Events in Non-valvular Atrial Fibrillation Patients

2021 ◽  
pp. 089719002110641
Author(s):  
Thane Feldeisen ◽  
Constantina Alexandris-Souphis ◽  
Brian Haymart ◽  
Xiaowen Kong ◽  
Eva Kline-Rogers ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Class ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Bleeding Event ◽  
Bleeding Events ◽  
Anticoagulation Management ◽  
Anticoagulation Clinics ◽  
The Individual

Background Bleeding events are common complications of oral anticoagulant drugs, including both warfarin and the direct oral anticoagulants (DOACs). Some patients have their anticoagulant changed or discontinued after experiencing a bleeding event, while others continue the same treatment. Differences in anticoagulation management between warfarin- and DOAC-treated patients following a bleeding event are unknown. Methods Patients with non-valvular atrial fibrillation from six anticoagulation clinics taking warfarin or DOAC therapy who experienced an International Society of Thrombosis and Haemostasis (ISTH)-defined major or clinically relevant non-major (CRNM) bleeding event were identified between 2016 and 2020. The primary outcome was management of the anticoagulant following bleeding (discontinuation, change in drug class, and restarting of same drug class). DOAC- and warfarin-treated patients were propensity matched based on the individual elements of the CHA2DS2-VASc and HAS-BLED scores as well as the severity of the bleeding event. Results Of the 509 patients on warfarin therapy and 246 on DOAC therapy who experienced a major or CRNM bleeding event, the majority of patients continued anticoagulation therapy. The majority of warfarin (231, 62.6%) and DOAC patients (201, 81.7%) restarted their previous anticoagulation. Conclusion Following a bleeding event, most patients restarted anticoagulation therapy, most often with the same type of anticoagulant that they previously had been taking.

Cardiovascular Risk Associated With Ibrutinib Use in Chronic Lymphocytic Leukemia: A Population-Based Cohort Study

2021 ◽  
pp. JCO.21.00693
Author(s):  
Husam Abdel-Qadir ◽  
Nasruddin Sabrie ◽  
Darryl Leong ◽  
Andrea Pang ◽  
Peter C. Austin ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Chronic Lymphocytic Leukemia ◽  
Index Date ◽  
Population Based ◽  
Lymphocytic Leukemia ◽  
Administrative Databases ◽  
Time Varying ◽  
Significant Difference ◽  
Ischemic Events

PURPOSE Ibrutinib reduces mortality in chronic lymphocytic leukemia (CLL). It increases the risk of atrial fibrillation (AF) and bleeding and there are concerns about heart failure (HF) and central nervous system ischemic events. The magnitude of these risks remains poorly quantified. METHODS Using linked administrative databases, we conducted a population-based cohort study of Ontario patients who were treated for CLL diagnosed between 2007 and 2019. We matched ibrutinib-treated patients with controls treated with chemotherapy but unexposed to ibrutinib on prior AF, age ≥ 66 years, anticoagulant exposure, and propensity for receiving ibrutinib. Study outcomes were AF-related health care contact, hospital-diagnosed bleeding, new diagnoses of HF, and hospitalizations for stroke and acute myocardial infarction (AMI). The cumulative incidence function was used to estimate absolute risks. We used cause-specific regression to study the association of ibrutinib with bleeding rates, while adjusting for anticoagulation as a time-varying covariate. RESULTS We matched 778 pairs of ibrutinib-treated and unexposed patients with CLL (N = 1,556). The 3-year incidence of AF-related health care contact was 22.7% (95% CI, 19.0 to 26.6) in ibrutinib-treated patients and 11.7% (95% CI, 9.0 to 14.8) in controls. The 3-year risk of hospital-diagnosed bleeding was 8.8% (95% CI, 6.5 to 11.7) in ibrutinib-treated patients and 3.1% (95% CI, 1.9 to 4.6) in controls. Ibrutinib-treated patients were more likely to start anticoagulation after the index date. After adjusting for anticoagulation as a time-varying covariate, ibrutinib remained positively associated with bleeding (HR, 2.58; 95% CI, 1.76 to 3.78). The 3-year risk of HF was 7.7% (95% CI, 5.4 to 10.6%) in ibrutinib-treated patients and 3.6% (95% CI, 2.2 to 5.4) in controls. There was no significant difference in the risk of ischemic stroke or AMI. CONCLUSION Ibrutinib is associated with higher risk of AF, bleeding, and HF, but not AMI or stroke.

Rivaroxaban Versus Low Molecular Weight Heparin For The Prevention Of Venous Thromboembolism After Orthopedic Surgery: A Population-Based Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 215-215 ◽  
Author(s):  
Alejandro Lazo-Langner ◽  
Jamie L. Fleet ◽  
Eric McArthur ◽  
Amit X. Garg
Keyword(s):  
Molecular Weight ◽  
Venous Thromboembolism ◽  
Emergency Room ◽  
Population Based ◽  
Low Molecular Weight ◽  
Routine Practice ◽  
Bleeding Events ◽  
Population Based Study ◽  
Major Hemorrhage ◽  
Significant Difference

Abstract Introduction Venous thromboembolism (VTE) occurs in up to 25% of patients undergoing total hip (THA) or knee arthroplasty (TKA) without the use of prophylactic anticoagulation. Low molecular weight heparins (LMWH) are the standard agents for preventing VTE in this setting. In recent years, rivaroxaban, apixaban and dabigatran have been approved for this indication and, although results from randomized trials suggest that they are non-inferior and potentially superior to LMWH, information regarding outcomes in routine use is lacking. Objectives To evaluate the safety and efficacy of rivaroxaban for the prevention of VTE in patients undergoing THR or TKR in routine practice. Methods We conducted a population-based retrospective cohort study using linked healthcare databases in Ontario, Canada, including information on hospital discharge, emergency room visits, medication use, demographics and physician billing. In Ontario older patients have universal drug coverage and thus we included patients aged 66 years or older who received an outpatient prescription for a LMWH, (including dalteparin, tinzaparin and enoxaparin) or rivaroxaban after discharge from THR or TKR between 2002 and 2012 across 121 hospitals. Patients were excluded if they had other indications for anticoagulation. Primary efficacy and safety outcomes in the 30 days after surgery were the occurrence of an Emergency Room visit or hospitalization with a VTE (either deep vein thrombosis or pulmonary embolism) or a hospitalization with non traumatic major hemorrhage, respectively. Secondary outcomes included the previous 2 endpoints at 90 days as well as hospitalization for digestive system endoscopy (a proxy for gastrointestinal hemorrhage) and all cause mortality, both at 30 and 90 days after surgery. Unadjusted and adjusted odds ratios with 95% confidence intervals (CI) were obtained using logistic regression and reported as relative risks (RR) (appropriate given the incidence observed). Results The cohort included 24,321 patients and there was no significant difference on over 35 baseline characteristics between the LMWH (n=11,471) and rivaroxaban (n=12,850) groups. The median age for both groups was 73 years, 14,366 patients were women (59.1%) and 8,612 patients (35.4%) underwent THR. Anticoagulants were prescribed for a median of 14 days after discharge (interquartile range 10 to 21). The main results are shown in the table. Results were consistent in multiple additional analyses accounting for years rivaroxaban was approved in provincial formulary, adjusting for potential confounders, secular trends, individual LMWH, prescriber characteristics, and for subgroup analyses examining THR and TKR separately. Conclusions In this routine practice population-based study, the use of rivaroxaban compared to LMWH was associated with a lower risk of VTE without an increase in bleeding events. Financial Support Canadian Institutes of Health Research; ICES Western Scholars program. Disclosures: Lazo-Langner: Pfizer: Honoraria; Leo Pharma: Honoraria; Boehringer Ingelheim: Honoraria.

scholarly journals Thromboprophylactic Efficacy and Safety of Anticoagulants After Arthroscopic Knee Surgery: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 25 ◽  
pp. 107602961988140
Author(s):  
Yang Yu ◽  
Shitao Lu ◽  
Jinpeng Sun ◽  
Wei Zhou ◽  
Hongjian Liu
Keyword(s):  
Major Bleeding ◽  
Bleeding Event ◽  
Control Group ◽  
Controlled Trials ◽  
Number Needed To Treat ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Bleeding Events ◽  
Increased Risk ◽  
Significant Difference

To examine the efficacy and safety of anticoagulants after knee arthroscopy (KA), PubMed, EMBASE, databases of Cochrane Central Register of Controlled Trials, and Chinese National Knowledge Infrastructure were searched up to August 2019 for randomized controlled trials (RCT). Seven RCTs including 4097 patients were demonstrated eligible according to the inclusion and exclusion criteria. The efficacy and safety of thromboprophylaxis were assessed and expressed using relative risk (RR) and 95% confidence intervals (95% CIs). The analysis of pooled data showed that anticoagulants group exhibited significant lower overall incidence of symptomatic and asymptomatic venous thromboembolism (VTE; RR = 0.35, 95% CIs: 0.22-0.55, P < .00001), significant higher incidence of all bleeding events (RR = 1.42, 95% CIs: 1.08-1.86, P = .01) compared to control group. However, no significant difference was found in terms of incidence of symptomatic VTE (RR = 0.43, 95% CIs: 0.15-1.21, P = .11) and incidence of major bleeding events (RR = 1.87, 95% CIs: 0.40-8.67, P = .42). The pooled number needed to treat to prevent one symptomatic or asymptomatic VTE was 26, while the pooled number needed to harm to cause one major bleeding event was 869. These results show that anticoagulants can effectively reduce the overall risk of VTE after KA; however, the increased risk of bleeding should be fully considered. Further studies are required to address the risk–benefit calculus and cost-effectiveness of anticoagulants after KA.

scholarly journals Suppression of gastric acid secretion decreased cardiovascular events independent of severe bleeding events in patients after percutaneous coronary intervention – sub-analysis from multicenter registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Kamishima ◽  
K Jujo ◽  
H Tanaka ◽  
T Hata ◽  
Y Ota ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acid Secretion ◽  
Gastric Acid Secretion ◽  
Cardiovascular Events ◽  
Bleeding Event ◽  
Coronary Intervention ◽  
Severe Bleeding ◽  
Bleeding Events ◽  
Percutaneous Coronary ◽  
Significant Difference

Abstract Background Suppression of gastric acid secretion by proton-pump inhibitor (PPI) or potassium-competitive acid blocker (P-CAB) has recently been developed as a standard strategy for preventing gastrointestinal bleeding for patients receiving antiplatelet therapy after percutaneous coronary intervention (PCI). However, there has been limited evidences on the association between PPI/P-CAB administration and adverse cardiovascular events in patients undergoing PCI. Purpose We aimed to evaluate the prognostic impact of the prescription of PPI/P-CAB on clinical outcomes in patients after PCI. Methods This study is a subanalysis from the TWINCRE registry that is a multicentral prospective cohort including patients who underwent PCI at 12 hospitals in Japan between 2017 and 2019. Among registered patients, we ultimately evaluated 1,428 patients who were followed-up. They were divided into two groups by the prescriptions of PPI or P-CAB at discharge for the index PCI; the PPI/P-CAB group (n=1,023), and the Non-PPI/P-CAB group (n=407). The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE) including death, acute coronary syndrome, stent thrombosis, hospitalization due to heart failure and ischemic stroke. Secondary endpoints was major bleeding events defined BARC3, 4 and 5. Results The average age of the study population was 70.3 years and 80.3% were male. Baseline clinical profiles were comparable between the groups, except that the PPI/P-CAB group included significantly higher rate of patients who had history of prior PCI (28.4% vs 18.7%, P=0.02). Additionally, there was no significant difference in the duration of dual antiplatelet therapy between the PPI/P-CAB group and Non-PPI/P-CAB group (average duration; 287±8 vs. 285±8 days, P=0.66). Overall, MACCE was developed in 132 patients (9.3%), and bleeding event was observed in 24 patients (1.7%) during 574 days of median follow-up period. Kaplan-Meier analysis showed that patients in the PPI/P-CAB group had a significantly lower rate of MACCE than those in the Non-PPI/P-CAB group (Log-rank test, p=0.0003, Figure 1A). Multivariate Cox regression analysis revealed that the prescription of PPI/P-CAB still was independently associated with the primary endpoint (hazard ratio 0.532, 95% confidence interval 0.369–0.766, p=0.0007), even after the adjustment by diverse covariates. Whereas, there was no significant difference in the bleeding event (p=0.64, Figure 1B). Conclusion PPI or P-CAB therapy was associated with better clinical outcomes after PCI, independent of the incidences of severe bleeding events. Figure 1 Funding Acknowledgement Type of funding source: None

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