Key result
Poor warfarin treatment quality (iTTR < 70%) in patients receiving triple therapy after PCI independently increased the risk of BARC type 2 bleeding complications by nearly threefold (HR 2.86) compared to iTTR ≥ 70%.
Why the study?
Triple therapy with warfarin, aspirin, and clopidogrel after PCI confers a high risk of bleeding, but whether warfarin treatment quality measured by iTTR is associated with bleeding complications was unknown.
Does poor warfarin treatment quality (iTTR < 70%) increase bleeding complications in patients receiving triple therapy after PCI?
Cohort (n=601)
Yes
Does poor warfarin treatment quality (iTTR < 70%) increase bleeding complications in patients receiving triple therapy after PCI?
Hazard Ratio: 2.86 (95% CI 1.25–6.53)
Absolute Event Rate: 9.3% vs 3.7%
p-value: p=0.005
Poor warfarin treatment quality (iTTR < 70%) and a history of anemia are strong independent predictors of bleeding in patients receiving triple therapy after PCI.
No takes yet. Share an insight, caveat, or question.
Low iTTR (<70%) was associated with higher bleeding during triple therapy post-PCI; supports closer monitoring but leaves open whether optimizing iTTR reduces events.
Wadell et al. (2018) conducted a cohort in Percutaneous coronary intervention (PCI) requiring triple antithrombotic therapy (n=601). Poor warfarin treatment quality (iTTR < 70%) vs. Good warfarin treatment quality (iTTR ≥ 70%) was evaluated on BARC type 2 bleeding complications up to 6 months after PCI (HR 2.86, 95% CI 1.25-6.53, p=0.005). Poor warfarin treatment quality (iTTR < 70%) in patients receiving triple therapy after PCI independently increased the risk of BARC type 2 bleeding complications by nearly threefold (HR 2.86) compared to iTTR ≥ 70%.
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