CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention
Introduction: The CRUSADE bleeding risk score (CBRS) accurately predicts major bleeding in non-ST segment elevation myocardial infarction NSTEMI patients. However, little information exists about its application in ST segment elevation myocardial infarction STEMI. We aimed to assess the ability of C...
| Authors: | ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Accepted version |
| Publication date: | 2013 |
| Country: | España |
| Institution: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repository: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:2445/224884 |
| Online Access: | https://hdl.handle.net/2445/224884 |
| Access Level: | Open access |
| Keyword: | Anticoagulants (Medicina) Coagulació sanguínia Hemorràgia Infart de miocardi Anticoagulants (Medicine) Blood coagulation Hemorrhage Myocardial infarction |
| _version_ | 1878738164158300160 |
|---|---|
| author | Ariza Solé, Albert |
| author2 | Sánchez Elvira, Guillermo Sánchez Salado, Jose Carlos Lorente-Tordera, Victoria Salazar Mendiguchía, Joel Sánchez Prieto, Remedios Romaguera-Torres, Rafael Ferreiro Gutiérrez, José Luis Gómez Hospital, Joan Antoni Cequier Fillat, Àngel R. |
| author2_role | author author author author author author author author author |
| author_browse | Ariza Solé, Albert Cequier Fillat, Àngel R. Ferreiro Gutiérrez, José Luis Gómez Hospital, Joan Antoni Lorente-Tordera, Victoria Romaguera-Torres, Rafael Salazar Mendiguchía, Joel Sánchez Elvira, Guillermo Sánchez Prieto, Remedios Sánchez Salado, Jose Carlos |
| author_facet | Ariza Solé, Albert Sánchez Elvira, Guillermo Sánchez Salado, Jose Carlos Lorente-Tordera, Victoria Salazar Mendiguchía, Joel Sánchez Prieto, Remedios Romaguera-Torres, Rafael Ferreiro Gutiérrez, José Luis Gómez Hospital, Joan Antoni Cequier Fillat, Àngel R. |
| author_role | author |
| collection | Recercat. Dipósit de la Recerca de Catalunya |
| description | Introduction: The CRUSADE bleeding risk score (CBRS) accurately predicts major bleeding in non-ST segment elevation myocardial infarction NSTEMI patients. However, little information exists about its application in ST segment elevation myocardial infarction STEMI. We aimed to assess the ability of CBRS to predict in-hospital major bleeding in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Materials and methods: We prospectively analyzed consecutive STEMI patients undergoing PPCI. Baseline characteristics, in-hospital complications and mid term mortality were recorded. Major bleeding was defined by the CRUSADE definition. Predictive ability of the CBRS was assessed by logistic regression method and the area under the ROC curve (AUC). Results: We included 1064 patients (mean age 63years). Mean CBRS value was 24. Most of patients (740/1064 (69.6%)) were in the two lowest risk quintiles of CBRS. Incidence of in-hospital major bleeding was 33/1064 (3.1%). The rates of in-hospital bleeding across the quintiles of risk groups were 0.4% (very low risk), 2.6% (low), 4.6% (moderate), 7.2% (high), and 13.4% (very high) (p 0.001). AUC was 0.80 (95% CI 0.73-0.87 p 0.001). In patients with radial access angiography (n=621) AUC was 0.81 (95% CI: 0.65-0.97). Mean follow up was 344days. Patients with bleeding events had higher mortality during follow up (HR 6.91; 95% CI 3.72-12.82; p 0.001). Conclusions: Our patients had a significantly lower bleeding risk as compared to CRUSADE NSTEMI population. CBRS accurately predicted major in-hospital bleeding in this different clinical scenario, including patients with radial artery approach. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_aa92eb417d95ef91ef516fb6d2f504cc |
| institution | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| instname_str | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:recercat.cat:2445/224884 |
| publishDate | 2013 |
| publishDateSort | 2013 |
| publisher | Elsevier Ltd. |
| publisherStr | Elsevier Ltd. |
| reponame_str | Recercat. Dipósit de la Recerca de Catalunya |
| spelling | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention Ariza Solé, Albert Sánchez Elvira, Guillermo Sánchez Salado, Jose Carlos Lorente-Tordera, Victoria Salazar Mendiguchía, Joel Sánchez Prieto, Remedios Romaguera-Torres, Rafael Ferreiro Gutiérrez, José Luis Gómez Hospital, Joan Antoni Cequier Fillat, Àngel R. Anticoagulants (Medicina) Coagulació sanguínia Hemorràgia Infart de miocardi Anticoagulants (Medicine) Blood coagulation Hemorrhage Myocardial infarction Introduction: The CRUSADE bleeding risk score (CBRS) accurately predicts major bleeding in non-ST segment elevation myocardial infarction NSTEMI patients. However, little information exists about its application in ST segment elevation myocardial infarction STEMI. We aimed to assess the ability of CBRS to predict in-hospital major bleeding in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Materials and methods: We prospectively analyzed consecutive STEMI patients undergoing PPCI. Baseline characteristics, in-hospital complications and mid term mortality were recorded. Major bleeding was defined by the CRUSADE definition. Predictive ability of the CBRS was assessed by logistic regression method and the area under the ROC curve (AUC). Results: We included 1064 patients (mean age 63years). Mean CBRS value was 24. Most of patients (740/1064 (69.6%)) were in the two lowest risk quintiles of CBRS. Incidence of in-hospital major bleeding was 33/1064 (3.1%). The rates of in-hospital bleeding across the quintiles of risk groups were 0.4% (very low risk), 2.6% (low), 4.6% (moderate), 7.2% (high), and 13.4% (very high) (p 0.001). AUC was 0.80 (95% CI 0.73-0.87 p 0.001). In patients with radial access angiography (n=621) AUC was 0.81 (95% CI: 0.65-0.97). Mean follow up was 344days. Patients with bleeding events had higher mortality during follow up (HR 6.91; 95% CI 3.72-12.82; p 0.001). Conclusions: Our patients had a significantly lower bleeding risk as compared to CRUSADE NSTEMI population. CBRS accurately predicted major in-hospital bleeding in this different clinical scenario, including patients with radial artery approach. Elsevier Ltd. https://hdl.handle.net/2445/224884 |
| spellingShingle | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention Ariza Solé, Albert Anticoagulants (Medicina) Coagulació sanguínia Hemorràgia Infart de miocardi Anticoagulants (Medicine) Blood coagulation Hemorrhage Myocardial infarction |
| status_str | acceptedVersion |
| title | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_full | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_fullStr | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_full_unstemmed | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_short | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_sort | CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| topic | Anticoagulants (Medicina) Coagulació sanguínia Hemorràgia Infart de miocardi Anticoagulants (Medicine) Blood coagulation Hemorrhage Myocardial infarction |
| topic_facet | Anticoagulants (Medicina) Coagulació sanguínia Hemorràgia Infart de miocardi Anticoagulants (Medicine) Blood coagulation Hemorrhage Myocardial infarction |
| url | https://hdl.handle.net/2445/224884 |