- NEWS . 21 Dec 2020
Bleeding events independently associated with risks of adverse outcomes in East Asian patients
Bleeding events conferred an increased risk of adverse outcomes in East Asian patients with acute myocardial infarction (AMI) and chronic coronary syndrome (CCS), according to a nationwide, retrospective cohort study in Taiwan.
Data from the National Health Insurance Research Database of Taiwan were used to compare the impact of bleeding on clinical outcomes in patients with AMI versus CCS. Patients with AMI (n=15,391) and CCS (n=19,724) who received dual antiplatelet therapy after coronary stenting between July 2007 and December 2010, were identified.
Findings revealed that at 1 year, AMI was associated with increased risks of myocardial infarction (AMI vs CCS: 0.38 vs 0.16 per 100 patient-months; p<0.01), all-cause death (0.49 vs 0.32 per 100 patient-months; p<0.01), and Bleeding Academic Research Consortium (BARC) type 3 bleeding (0.22 vs 0.13 per 100 patient-months; p<0.01) compared with CCS. Conversely, the risk of BARC type 2 bleeding was marginally higher in the CCS patients than in the AMI patients (AMI vs CCS: 1.32 vs 1.4 per 100 person-months; p=0.06).
Importantly, bleeding was found to be an independent predictor of myocardial infarction, stroke and all-cause death in this East Asian population, regardless of the initial presentation. Among the patients with bleeding, AMI was significantly associated with a higher ischaemic risk at 1 year after bleeding compared with CCS. Lastly, the 1-year mortality after bleeding was comparable between the two groups after propensity score weighting.
Tung Y-C, et al. Impact of bleeding during dual antiplatelet therapy in patients with coronary artery disease. Sci Rep 2020;10:21345.