Bleeding Outcomes After Percutaneous Coronary Intervention in the Past Two Decades in Japan-From the CREDO-Kyoto Registry Cohort-2 and Cohort-3

被引：2

作者：

Natsuaki, Masahiro ^{[1
]}

Morimoto, Takeshi ^{[2
]}

Shiomi, Hiroki ^{[3
]}

Yamamoto, Ko ^{[3
]}

Yamaji, Kyohei ^{[4
]}

Watanabe, Hirotoshi ^{[3
]}

Uegaito, Takashi ^{[5
]}

Matsuda, Mitsuo ^{[5
]}

Tamura, Toshihiro ^{[6
]}

Taniguchi, Ryoji ^{[7
]}

Inoko, Moriaki ^{[8
]}

Mabuchi, Hiroshi ^{[9
]}

Takeda, Teruki ^{[9
]}

Domei, Takenori ^{[4
]}

Shirotani, Manabu ^{[10
]}

Ehara, Natsuhiko ^{[11
]}

Eizawa, Hiroshi ^{[12
]}

Ishii, Katsuhisa ^{[13
]}

Tanaka, Masaru ^{[14
]}

Inada, Tsukasa ^{[14
]}

Onodera, Tomoya ^{[15
]}

Nawada, Ryuzo ^{[15
]}

Shinoda, Eiji ^{[16
]}

Yamada, Miho ^{[16
]}

Yamamoto, Takashi ^{[17
]}

Sakai, Hiroshi ^{[17
]}

Toyofuku, Mamoru ^{[18
]}

Tamura, Takashi ^{[18
]}

Takahashi, Mamoru ^{[19
]}

Tada, Tomohisa ^{[20
]}

Sakamoto, Hiroki ^{[20
]}

Tada, Takeshi ^{[21
]}

Kaneda, Kazuhisa ^{[3
]}

Miki, Shinji ^{[22
]}

Aoyama, Takeshi ^{[23
]}

Suwa, Satoru ^{[24
]}

Sato, Yukihito ^{[7
]}

Ando, Kenji ^{[4
]}

Furukawa, Yutaka ^{[11
]}

Nakagawa, Yoshihisa ^{[17
]}

Kadota, Kazushige ^{[21
]}

Kimura, Takeshi ^{[3
]}

机构：

[1] Saga Univ, Dept Cardiovasc Med, Saga, Japan

[2] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

[3] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan

[4] Kokura Mem Hosp, Dept Cardiol, Kitakyushu, Fukuoka, Japan

[5] Kishiwada City Hosp, Dept Cardiol, Kishiwada, Japan

[6] Tenri Hosp, Dept Cardiol, Tenri, Nara, Japan

[7] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, Amagasaki, Hyogo, Japan

[8] Kitano Hosp, Dept Cardiol, Osaka, Japan

[9] Koto Mem Hosp, Dept Cardiol, Higashiomi, Japan

[10] Kindai Univ, Dept Cardiol, Nara Hosp, Ikoma, Japan

[11] Kobe City Med Ctr, Dept Cardiovasc Med, Gen Hosp, Kobe, Hyogo, Japan

[12] Kobe City Nishi Kobe Med Ctr, Dept Cardiovasc Med, Kobe, Hyogo, Japan

[13] Kansai Denryoku Hosp, Dept Cardiol, Osaka, Japan

[14] Osaka Red Cross Hosp, Dept Cardiol, Osaka, Japan

[15] Shizuoka City Shizuoka Hosp, Dept Cardiol, Shizuoka, Japan

[16] Hamamatsu Rosai Hosp, Dept Cardiol, Hamamatsu, Shizuoka, Japan

[17] Shiga Univ Med Sci Hosp, Dept Cardiol, Otsu, Shiga, Japan

[18] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, Wakayama, Japan

[19] Shimabara Hosp, Dept Cardiol, Kyoto, Japan

[20] Shizuoka Prefectural Gen Hosp, Dept Cardiol, Shizuoka, Japan

[21] Kurashiki Cent Hosp, Dept Cardiol, Kurashiki, Okayama, Japan

[22] Mitsubishi Kyoto Hosp, Dept Cardiol, Kyoto, Japan

[23] Shimada Municipal Hosp, Div Cardiol, Shimada, Japan

[24] Juntendo Univ, Dept Cardiol, Shizuoka Hosp, Izunokuni, Japan

来源：

CIRCULATION JOURNAL | 2022年 / 86卷 / 05期

关键词：

  Coronary artery disease; High bleeding risk; Percutaneous coronary intervention; DUAL ANTIPLATELET THERAPY; BARE-METAL; CARDIOVASCULAR EVENTS; STENT; CLOPIDOGREL; MONOTHERAPY; TICAGRELOR; TRENDS;

D O I：

10.1253/circj.CJ-21-0526

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Optimal intensity is unclear for P2Y12 receptor blocker therapy after percutaneous coronary intervention (PCI) in realMethods and Results: From the CREDO-Kyoto Registry, the current study population consisted of 25,419 patients (Cohort-2: n=12,161 and Cohort-3: n=13,258) who underwent their first PCI. P2Y12 receptor blocker therapies were reduced dose of ticlopidine (200 mg/day), and global dose of clopidogrel (75 mg/day) in 87.7% and 94.8% of patients in Cohort-2 and Cohort-3, respectively. Cumulative 3-year incidence of GUSTO moderate/severe bleeding was significantly higher in Cohort-3 than in Cohort-2 (12.1% and 9.0%, P<0.0001). After adjusting 17 demographic factors and 9 management factors potentially related to the bleeding events other than the type of P2Y12 receptor blocker, the higher bleeding risk in Cohort-3 relative to Cohort-2 remained significant (hazard ratio (HR): 1.52 95% confidence interval (CI) 1.37-1.68, P<0.0001). Cohort-3 compared with Cohort-2 was not associated with lower adjusted risk for myocardial infarction/ischemic stroke (HR: 0.96, 95% CI: 0.87-1.06, P=0.44). Conclusions: In this historical comparative study, Cohort-3 compared with Cohort-2 was associated with excess bleeding risk, which might be at least partly explained by the difference in P2Y12 receptor blockers.

引用

页码：748 / +

页数：30

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