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Predictors and consequences of postdischarge gastrointestinal bleeding after percutaneous coronary intervention.
Cardiovascular Therapeutics 2018 October
AIM: To evaluate the incidence, predictors, and outcomes of postdischarge gastrointestinal bleeding (GIB) in patients underwent percutaneous coronary intervention (PCI) in a 2-year follow-up study.
METHODS AND RESULTS: All consecutive patients who underwent PCI throughout 2013 were enrolled. Multivariable cox proportional hazards regression were used to identify predictors of postdischarge GIB and 2-year major adverse cardiovascular and cerebrovascular events (MACCE). Among 10 637 enrolled patients, postdischarge GIB events occurred in 123 (1.1%) patients at a median time of 329 days (interquartile range: 191-504 days). Predictor of postdischarge GIB included renal dysfunction and use of ticagrelor. There was no significant association between postdischarge GIB and MACCE (7.3% vs 12.0%, P = .092). Among whole population, 310 (2.91%) patients had dual antiplatelet therapy (DAPT) cessation. DAPT cessation was strongly associated with 2-year mortality (21.6% vs 0.4%, P < .001).
CONCLUSION: In this large cohort of real-world patients after PCI, postdischarge GIB was not significantly associated with MACCE up to 2 years of follow-up but lead to an increase in DAPT cessation, and DAPT cessation was strongly associated with 2-year mortality.
METHODS AND RESULTS: All consecutive patients who underwent PCI throughout 2013 were enrolled. Multivariable cox proportional hazards regression were used to identify predictors of postdischarge GIB and 2-year major adverse cardiovascular and cerebrovascular events (MACCE). Among 10 637 enrolled patients, postdischarge GIB events occurred in 123 (1.1%) patients at a median time of 329 days (interquartile range: 191-504 days). Predictor of postdischarge GIB included renal dysfunction and use of ticagrelor. There was no significant association between postdischarge GIB and MACCE (7.3% vs 12.0%, P = .092). Among whole population, 310 (2.91%) patients had dual antiplatelet therapy (DAPT) cessation. DAPT cessation was strongly associated with 2-year mortality (21.6% vs 0.4%, P < .001).
CONCLUSION: In this large cohort of real-world patients after PCI, postdischarge GIB was not significantly associated with MACCE up to 2 years of follow-up but lead to an increase in DAPT cessation, and DAPT cessation was strongly associated with 2-year mortality.
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