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Am J Cardiol ; 125(8): 1142-1147, 2020 04 15.
Article in English | MEDLINE | ID: mdl-32087994

ABSTRACT

Bleeding risk stratification is an unresolved issue in older adults. Anemia may reflect subclinical blood losses that can be exacerbated after percutaneous coronary intervention . We sought to prospectively determine the contribution of anemia to the risk of bleeding in 448 consecutive patients aged 75 or more years, treated by percutaneous coronary interventions without concomitant indication for oral anticoagulation. We evaluated the effect of WHO-defined anemia on the incidence of 1-year nonaccess site-related major bleeding. The prevalence of anemia was 39%, and 13.1% of anemic and 5.2% of nonanemic patients suffered a bleeding event (hazard ratio 2.75, 95% confidence interval 1.37 to 5.54, p = 0.004). Neither PRECISE-DAPT nor CRUSADE scores were superior to hemoglobin for the prediction of bleeding. In conclusion, anemia is a powerful predictor of bleeding with potential utility for simplifying tailoring therapies.


Subject(s)
Acute Coronary Syndrome/surgery , Anemia/epidemiology , Coronary Artery Disease/surgery , Percutaneous Coronary Intervention/methods , Platelet Aggregation Inhibitors/therapeutic use , Postoperative Hemorrhage/epidemiology , Acute Coronary Syndrome/epidemiology , Aged , Aged, 80 and over , Angina, Unstable/epidemiology , Angina, Unstable/surgery , Anticoagulants/therapeutic use , Antithrombins/therapeutic use , Aspirin/therapeutic use , Cause of Death , Clopidogrel/therapeutic use , Comorbidity , Coronary Artery Disease/epidemiology , Drug-Eluting Stents , Female , Gastrointestinal Hemorrhage/chemically induced , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/mortality , Hemorrhage/chemically induced , Hemorrhage/epidemiology , Hemorrhage/mortality , Heparin/therapeutic use , Hirudins , Humans , Intracranial Hemorrhages/chemically induced , Intracranial Hemorrhages/epidemiology , Intracranial Hemorrhages/mortality , Kaplan-Meier Estimate , Male , Myocardial Infarction/epidemiology , Myocardial Infarction/surgery , Peptide Fragments/therapeutic use , Postoperative Care , Postoperative Hemorrhage/chemically induced , Postoperative Hemorrhage/mortality , Prasugrel Hydrochloride/therapeutic use , Proportional Hazards Models , Prospective Studies , Recombinant Proteins/therapeutic use , Risk Assessment , Stents , Ticagrelor/therapeutic use , Urologic Diseases/chemically induced , Urologic Diseases/epidemiology , Urologic Diseases/mortality
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