Relationship between coronary artery calcium score and bleeding events after percutaneous coronary intervention in chronic coronary syndrome
Relationship between coronary artery calcium score and bleeding events after percutaneous coronary intervention in chronic coronary syndrome
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DOI：
10.1007/s00380-023-02248-7
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发表时间：
2023-02-27
影响因子：
1.5
通讯作者：
Kaikita, Koichi
中科院分区：
文献类型：
--
作者：
Komaki, Soichi;Ishii, Masanobu;Kaikita, Koichi
冠状动脉钙化(CAC)与慢性冠脉综合征(CCS)患者经皮冠状动脉介入治疗(PCI)后出血事件的关系尚不清楚。本研究旨在研究CCS患者行经皮冠状动脉介入治疗后CAC评分与临床结果之间的关系。这项回顾性观察研究包括295名连续接受多探测器计算机断层扫描的患者，并计划进行他们的第一次择期经皮冠状动脉介入治疗。根据CAC评分(低：400)将患者分为两组。出血风险评估采用高出血风险学术研究联盟(ARC-HBR)标准。主要的临床结果是术后1年内发生重大出血事件，定义为出血学术研究联盟(BARC3或5)。高CAC值组符合ARC-HBR标准的患者比例高于低CAC值组(52.7%对31.3%，p<；0.001)。Kaplan-Meier生存分析显示，与低CAC评分组相比，高CAC评分组的主要出血事件发生率更高(p<；0.001)。此外，多变量COX回归分析显示，CAC评分高是冠状动脉介入术后第一年发生重大出血事件的独立决定因素。在CCS患者中，CAC评分高与冠状动脉介入术后大出血事件的发生率显著相关。
The relationship between coronary artery calcium (CAC) and bleeding events after percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is not well established. This study aimed to examine the association between CAC scores and clinical outcomes after PCI in patients with CCS. This retrospective observational study included 295 consecutive patients who underwent multidetector computer tomography and were scheduled for their first elective PCI. Patients were categorized into two groups based on the CAC scores (low: 400). The bleeding risk was evaluated using the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria. The primary clinical outcome was a major bleeding event within 1 year after PCI, defined as Bleeding Academic Research Consortium (BARC) 3 or 5. The high CAC score group had a higher proportion of patients meeting the ARC-HBR criteria than the low CAC score group (52.7% vs. 31.3%, p < 0.001). Kaplan-Meier survival analysis showed that the incidence of major bleeding events was higher in the high CAC score group as compared to the low CAC score group (p < 0.001). Furthermore, multivariate Cox regression anal ysis revealed that a high CAC score was an independent determinant of major bleeding events during the first year after PCI. A high CAC score is significantly associated with the incidence of major bleeding events after PCI in CCS patients.