Validation of a High Bleeding Risk Definition in Cancer Patients undergoing Percutaneous Coronary Intervention.

IF 8.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European journal of preventive cardiology Pub Date : 2024-12-21 DOI:10.1093/eurjpc/zwae399

Mauro Gitto, Sean Gilhooley, Kenneth Smith, Birgit Vogel, Samantha Sartori, Benjamin Bay, Prakash Krishnan, Joseph Sweeny, Angelo Oliva, Pedro Moreno, Francesca Maria Di Muro, Parasuram Melarcode Krishnamoorthy, Annapoorna Kini, George Dangas, Roxana Mehran, Samin Sharma

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引用次数: 0

Abstract

Aim: Due to the absence of validated bleeding risk tools in cancer patients undergoing percutaneous coronary intervention (PCI), we aimed to validate an adapted version of the Academic Research Consortium (ARC) High Bleeding Risk (HBR) criteria.

Methods: Consecutive patients with active or remission cancer undergoing PCI between 2012 and 2022 at Mount Sinai Hospital (New York, USA) were included. Patients were considered at HBR if they met at least one of the major ARC-HBR criteria, other than cancer, or two minor criteria.The primary endpoint was a composite of periprocedural in-hospital or post-discharge bleeding at 1 year. The key secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE), including death, myocardial infarction, or stroke.

Results: Of the 2,007 cancer patients included in this study, 1,142 (56.9%) were classified as HBR. Moderate to severe anemia was the most prevalent major HBR criterion (35%). At 1 year, the incidence of bleeding was significantly higher in HBR compared to non-HBR patients (10.9% vs. 3.9%, adj. HR: 2.36, 95% CI: 1.57-3.53, p<0.001), mainly driven by higher periprocedural bleeding. Similarly, HBR patients were at higher risk of MACCE (11.0% vs. 3.2%, adj. HR: 2.78, 95% CI: 1.72-4.47, p<0.001) and death (8.8% vs. 2.2%, adj. HR: 3.28, 95% CI: 1.87-5.77, p<0.001) than non-HBR patients.

Conclusions: An adapted version of the ARC-HBR criteria, in which cancer is not a major criterion, effectively delineates cancer patients undergoing PCI who are at HBR. Cancer patients at HBR according to this definition also exhibited a higher mortality risk. .

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来源期刊

European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

12.50

自引率

12.00%

发文量

601

审稿时长

3-8 weeks

期刊介绍： European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.