Implications of bleeding on subsequent cardiovascular events in patients with atrial fibrillation after acute coronary syndrome or PCI

医学 传统PCI 心脏病学 内科学 蒂米 心房颤动 经皮冠状动脉介入治疗 心肌梗塞 急性冠脉综合征 冲程(发动机) 临床终点 随机对照试验 机械工程 工程类
作者
Ran Mo,Haoyu Wang,Yanmin Yang,Han Zhang,Ni Suo,Jingyang Wang
出处
期刊:Thrombosis Research [Elsevier BV]
卷期号:229: 243-251 被引量:2
标识
DOI:10.1016/j.thromres.2023.08.002
摘要

Introduction The association between bleeding and subsequent major adverse cardiac and cerebrovascular events (MACCE) remains poorly characterized. We aimed to evaluate the impact of hemorrhagic events in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI). Materials and methods A total of 1877 consecutive patients with AF and ACS or undergoing PCI were prospectively recruited. The primary endpoint was MACCE, including all-cause death, myocardial infarction, ischemic stroke, systemic embolism or ischemia-driven revascularization during follow-up. Post-discharge bleeding was graded according to TIMI criteria. Associations between bleeding and subsequent MACCE were examined using time-dependent multivariate Cox regression after adjusting for baseline covariates and the time from bleeding. Results During a median follow-up of 34.2 months, 341 (18.2 %) had TIMI major or minor bleeding events, of whom 86 (25.2 %) also experienced MACCE. The risk of MACCE was significantly higher in patients with bleeding than those without (8.85 % versus 6.99 % per patient-year; HR, 1.568, 95 % CI, 1.232–1.994). In patients who had both bleeding and MACCE, 65.1 % (56 of 86) bleeding events occurred first. Temporal gradients in MACCE risk after major bleeding was highest within 30 days (HRadj, 23.877; 95 % CI, 12.810–44.506) and remained significant beyond 1 year (HRadj, 3.640; 95 % CI, 1.278–10.366). Minor bleeding was associated with increased risk of MACCE within 1 year. Conclusions In patients with AF and ACS or PCI, major and minor bleeding were associated with subsequent MACCE with time-dependency. Our findings may aid in better defining net clinical benefit of optimal antithrombotic therapy.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
每天都在找完成签到,获得积分10
2秒前
2秒前
3秒前
淡烟流水发布了新的文献求助10
4秒前
4秒前
小李发布了新的文献求助30
5秒前
汉堡包应助明芬采纳,获得30
5秒前
爆米花应助彭栋采纳,获得10
5秒前
6秒前
6秒前
MeiyanZou完成签到 ,获得积分10
6秒前
9秒前
9秒前
潇湘雪月发布了新的文献求助10
10秒前
10秒前
10秒前
11秒前
感动黄豆发布了新的文献求助10
11秒前
hhhblabla应助东方红采纳,获得10
13秒前
Poker应助sb采纳,获得10
14秒前
Ginger发布了新的文献求助10
14秒前
吃骨头的猫完成签到,获得积分10
14秒前
小李完成签到,获得积分10
14秒前
14秒前
15秒前
明芬发布了新的文献求助30
17秒前
17秒前
Smile完成签到,获得积分10
17秒前
Chaoe完成签到,获得积分10
20秒前
建国发布了新的文献求助10
21秒前
闪闪w发布了新的文献求助10
24秒前
淡烟流水完成签到,获得积分10
24秒前
俏皮芷蕊完成签到,获得积分10
25秒前
完美世界应助忐忑的阑香采纳,获得10
25秒前
华仔应助兴奋千兰采纳,获得10
30秒前
Ginger完成签到,获得积分10
31秒前
潇湘雪月发布了新的文献求助10
34秒前
科研通AI5应助科研通管家采纳,获得10
36秒前
36秒前
佳琳有乐完成签到,获得积分10
36秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989115
求助须知:如何正确求助?哪些是违规求助? 3531367
关于积分的说明 11253688
捐赠科研通 3269986
什么是DOI,文献DOI怎么找? 1804868
邀请新用户注册赠送积分活动 882078
科研通“疑难数据库(出版商)”最低求助积分说明 809105