Incidence, Prediction and Outcomes of Major Bleeding After Percutaneous Coronary Intervention in Chinese Patients (JACC: Asia June 2022)

Incidence, Prediction and Outcomes of Major Bleeding After Percutaneous Coronary Intervention in Chinese Patients (JACC: Asia June 2022) is organized by American College of Cardiology (ACC).,Date of Release: June 21, 2022 ,Term of Approval/Date of CME/MOC/ECME Expiration: June 20, 2023 ,Description:,Background: The patterns of late major bleeding (MB) after percutaneous coronary intervention (PCI) remained unknown in Chinese patients.,Objective: ,To determine the incidence, prediction, and long-term outcomes of late MB in Chinese patients.,Method: ,This was a retrospective cohort study from 14 hospitals in Hong Kong. Participants were patients undergoing first-time PCI without MB within 30 days or death within 1 year. Patients were stratified by the presence of late MB, defined as MB between 30 to 365 days. The primary endpoint was all-cause mortality. The secondary endpoints were major adverse cardiac events (MACE).,Results:,A total of 32,057 patients were analyzed. After adjustment for baseline characteristics, peri-procedural characteristics, and medications on discharge, the risks of all-cause mortality at 5 years were significantly higher with late MB (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.92 to 2.41; P<0.001). Late MB was also associated with a higher risk of MACE (HR, 1.57; 95% CI 1.03 to 1.50; P<0.001), myocardial infarction (HR, 1.25; 95% CI, 1.04 to 1.52; P=0.02) and stroke (HR, 1.38; 95% CI, 1.09 to 1.73; P=0.006). The CARDIAC score had good discriminating power for the prediction of MB within 365 days (area under the receiver operator curve 0.76).,Conclusions: ,Late MB was independently associated with a higher risk of mortality, MACE, myocardial infarction, and stroke in patients undergoing PCI. The CARDIAC score is a simple model that can predict MB after PCI. Prevention of MB represents an important strategy to optimize cardiovascular outcomes for patients undergoing PCI.