Evaluation of the Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients Bleeding Score for Predicting the Long-term Out-of-hospital Bleeding Risk in Chinese Patients after Percutaneous Coronary Intervention  

作　　者：Xue-Yan Zhao Jian-Xin Li Xiao-Fang Tang Jing-Jing Xu Ying Song Lin Jiang Jue Chen Lei Song Li-Jian Gao Zhan Gao Shu-Bin Qiao Yue-Jin Yang Run-Lin Gao Bo Xu Jin-Qing Yuan 

机构地区：[1]Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China [2]Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

出　　处：《Chinese Medical Journal》2018年第12期1406-1411,共6页中华医学杂志（英文版）

摘　　要：Background： The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients （PARIS） bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention （PCI）. However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score＇s predictive value of bleeding in patients alter PCI in the Chinese population. Methods： We perforined a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China. We defined the primary end point as major bleeding （MB） according to Bleeding Academic Research Consortium definition criteria including Type 2, 3, or 5. The predictive value of the PARIS bleeding score was assessed with the area under the receiver operating characteristic （AUROC） curve. Results： Of 9782 patients, 245 （2.50%） MB events occurred during the 2 years of follow-up. The PAP, IS bleeding score was significantly higher in the MB group than that of non-MB group （4.00 [3.00, 5.00] vs. 3.00 [2.00, 5.00], Z=3.71, P 〈 0.001 ）. According to risk stratification of the PARIS bleeding score, the bleeding risk in the intermediate- and high-risk groups was 1.50 times （hazard ratio [HR]： 1.50; 95% confidence interval [CI]： 1.160-1.950; P=0.002） and 2.27 times higher （HR： 2.27; 95% CI： 1,320-3.900： P=0.003） than that in the low-risk group. The PARIS bleeding score showed a moderate predictive value for MB in the overall population （AUROC： 0.568, 95% CI： 0.532-0.605; P 〈 0.001 ） and acute coronary syndrome （ACS） subgroup （AUROC： 0.578, 95% CI： 0.530-0.626; P = 0.001 ） and tended to be predictive in the non-ACS subgroup （AUROC： 0.556, 95% CI： 0,501 0.611; P = 0.054）.Background： The Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients （PARIS） bleeding score is a novel score for predicting the out-of-hospital bleeding risk after percutaneous coronary intervention （PCI）. However, whether this score has the same value in non-European and American populations is unclear. This study aimed to assess the PARIS bleeding score＇s predictive value of bleeding in patients alter PCI in the Chinese population. Methods： We perforined a prospective, observational study of 10,724 patients who underwent PCI from January to December 2013, in Fuwai Hospital, China. We defined the primary end point as major bleeding （MB） according to Bleeding Academic Research Consortium definition criteria including Type 2, 3, or 5. The predictive value of the PARIS bleeding score was assessed with the area under the receiver operating characteristic （AUROC） curve. Results： Of 9782 patients, 245 （2.50%） MB events occurred during the 2 years of follow-up. The PAP, IS bleeding score was significantly higher in the MB group than that of non-MB group （4.00 [3.00, 5.00] vs. 3.00 [2.00, 5.00], Z=3.71, P 〈 0.001 ）. According to risk stratification of the PARIS bleeding score, the bleeding risk in the intermediate- and high-risk groups was 1.50 times （hazard ratio [HR]： 1.50; 95% confidence interval [CI]： 1.160-1.950; P=0.002） and 2.27 times higher （HR： 2.27; 95% CI： 1,320-3.900： P=0.003） than that in the low-risk group. The PARIS bleeding score showed a moderate predictive value for MB in the overall population （AUROC： 0.568, 95% CI： 0.532-0.605; P 〈 0.001 ） and acute coronary syndrome （ACS） subgroup （AUROC： 0.578, 95% CI： 0.530-0.626; P = 0.001 ） and tended to be predictive in the non-ACS subgroup （AUROC： 0.556, 95% CI： 0,501 0.611; P = 0.054）.

关 键 词：Bleeding： Percutaneous Coronary Intervention Prognosis 

分 类 号：R541.4[医药卫生—心血管疾病]