461Modulation of ischemic and bleeding risk by peripheral artery disease after an acute coronary syndrome
| العنوان: | 461Modulation of ischemic and bleeding risk by peripheral artery disease after an acute coronary syndrome |
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| المؤلفون: | M Cespon Fernandez, B Caneiro Queija, R Cobas Paz, P J Flores Blanco, Emad Abu-Assi, F Cambronero Sanchez, Sergio Manzano-Fernández, S Raposeiras Roubin, F D'Ascenzo, E Lopez Rodriguez, J P Simao Henriques, I Munoz Pousa, Jorge F. Saucedo, A Ariza Sole, A Iniguez Romo |
| المصدر: | European Heart Journal. 40 |
| بيانات النشر: | Oxford University Press (OUP), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, Acute coronary syndrome, Prasugrel, business.industry, Arterial disease, Ischemia, Disease, medicine.disease, Internal medicine, Epidemiology, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Risk assessment, Ticagrelor, medicine.drug |
| الوصف: | Introduction Peripheral artery disease (PAD) is associated with heightened ischemic and bleeding risk in patients with acute coronary syndrome (ACS). With this study from real-life patients, we try to analyze the balance between ischemic and bleeding risk during treatment with dual antiplatelet therapy (DAPT) after an ACS according to the presence or not of PAD. Methods The data analyzed in this study were obtained from the fusion of 3 clinical registries of ACS patients: BleeMACS (2004–2013), CardioCHUVI/ARRITXACA (2010–2016) and RENAMI (2013–2016). All 3 registries include consecutive patients discharged after an ACS with DAPT and undergoing PCI. The merged data set contain 26,076 patients. A propensity-matched analysis was performed to match the baseline characteristics of patients with and without PAD. The impact of prior PAD in the ischemic and bleeding risk was assessed by a competitive risk analysis, using a Fine and Gray regression model, with death being the competitive event. For ischemic risk we have considered a new acute myocardial infarction (AMI), whereas for bleeding risk we have considered major bleeding (MB) defined as bleeding requiring hospital admission. Follow-up time was censored by DAPT suspension/withdrawal. Results From the 26,076 ACS patients, 1,600 have PAD (6.1%). Patients with PAD were older, and with more cardiovascular risk factors. DAPT with prasugrel/ticagrelor was less frequently prescribed in patients with PAD in comparison with the rest of the population (8.2% vs 22.8%, p Conclusions PAD was associated with higher ischemic and bleeding risk after hospital discharge for ACS treated with DAPT. However, the balance between ischemic and bleeding risk was positive for patients with PAD in comparison with patients without PAD. As summary, ACS patients with PAD had an ischemic risk greater than the bleeding risk. |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::cc4ab9b3d6c1bc0e3c1a60038eb864a8 https://doi.org/10.1093/eurheartj/ehz747.0120 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........cc4ab9b3d6c1bc0e3c1a60038eb864a8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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