Prognostic and Practical Validation of ESC/EACTS High Ischemic Risk Definition on Long-Term Thrombotic and Bleeding Events in Contemporary PCI Patients

Figures

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  Supplementary Fig.1.. Kaplan–Meier event curves for clinically relevant bleeding stratified by (A) four PRECISE-DAPT risk strata (very low: ≤ 10, low: 11-17, moderate: 18-24, and high: ≥ 25 points), (B) three PRECISE-DAPT risk strata (low: ≤ 17, moderate: 18-24, and high: ≥ 25 points), (C) three PARIS risk strata (low: 0-3, intermediate: 4-7, and high: ≥ 8 points)

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  Supplementary Fig.2. Calibration plots showing the predicted (x axis) probability vs observed (y axis) 30-month clinically relevant bleeding-free survival according to PRECISE-DAPT score (A) and PARIS bleeding score (B). The diagonal line represents the perfect calibration (observed=calibration). Observed clinically relevant bleeding-free survival is represented with 95% confidence intervals (error bars)

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  Fig.1.. Prevalence of the ESC/EACTS-endorsed HIR criteria components in the overall population HIR=high ischemic risk

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  Fig.2. Time-to-Event Curves for TVF (A), POCO (B), cardiac death (C), MI (D), definite/probable ST (E), TVR (F), and clinically relevant bleeding (G) according to ESC/EACTS-endorsed HIR features. HIR=high ischemic risk; POCO=patient-oriented composite outcome; ST=stent thrombosis; TVR=target vessel revascularization; TVF=target vessel failure

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  Supplementary Fig.3. Time-to-Event Curves for TVF (A), POCO (B), and clinically relevant bleeding (C) stratified by the number of ESC/EACTS-endorsed HIR features. HIR=high ischemic risk; POCO=patient-oriented composite outcome; TVF=target vessel failure

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  Fig.3. Adjusted hazard ratio of each ESC/EACTS–HIR criterion for target vessel failure, patient-oriented composite outcome and clinically relevant bleeding. Blue indicates unadjusted results. Red indicates results adjusted by following variables. Green indicates results adjusted by following variables and all ESC/EACTS–HIR features. For ischemic endpoints (TVF and POCO): age, sex, body mass index, hypertension, current smoking, left ventricular ejection fraction, peripheral artery disease, prior revascularization (percutaneous coronary intervention and/or coronary artery bypass graft), acute coronary syndrome, mean stent diameter, type of DES implanted, and DAPT duration (as a time-adjusted covariate); for clinically relevant bleeding: age, sex, body mass index, hypertension, prior major bleeding event, anemia, oral anticoagulation use at discharge, and DAPT duration (as a time-adjusted covariate). CI=confidence interval; CTO=chronic total occlusion; HR=hazard ratio; TVF=target vessel failure; POCO=patient-oriented composite outcome;

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  Fig.4. Time-to-Event Curves for TVF (A), POCO (B), cardiac death (C), MI (D), definite/probable ST (E), TVR (F), and clinically relevant bleeding (G) according to ESC/EACTS-endorsed HIR features and HBR status. HIR=high ischemic risk; HBR=high bleeding risk; POCO=patient-oriented composite outcome; ST=stent thrombosis; TVR=target vessel revascularization; TVF=target vessel failure

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  Fig.5. Cumulative Incidence of Endpoint Events according to ESC/EACTS–HIR criteria and bleeding risk categorization. The endpoint events were stratified by ESC/EACTS-endorsed HIR criteria and four bleeding risk strata from PRECISE-DAPT score. Outcomes were analyzed comparing ESC/EACTS-endorsed HIR criteria among subgroups of patients with very low ( n =6141), low ( n =2119), moderate ( n =1225), and high bleeding risk ( n =682). Relative impact of ESC/EACTS-endorsed HIR criteria was consistent for the outcomes of TVF, POCO, and clinically relevant bleeding, independent of the bleeding risk status. HIR=high ischemic risk; POCO=patient-oriented composite outcome; TVF=target vessel failure

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  Supplementary Fig.4. Cumulative Incidence of Endpoint Events according to ESC/EACTS-HIR criteria and bleeding risk categorization. The endpoint events were stratified by ESC/EACTS-endorsed HIR criteria and three bleeding risk categories based on PARIS bleeding risk score. Outcomes were analyzed comparing ESC/EACTS-endorsed HIR criteria among subgroups of patients with low ( n =5178), intermediate ( n =4519), and high bleeding risk ( n =470). Relative impact of ESC/EACTS-endorsed HIR criteria were consistent for the outcomes of TVF, POCO, and clinically relevant bleeding independent of the bleeding risk status. HIR=high ischemic risk; POCO=patient-oriented composite outcome; TVF=target vessel failure