Key result
Postdischarge gastrointestinal bleeding after PCI was not significantly associated with 2-year MACCE (7.3% vs 12.0%, P=0.092) but led to an increase in DAPT cessation.
Why the study?
What are the predictors and consequences of postdischarge gastrointestinal bleeding in patients who underwent PCI?
Cohort (n=10,637)
What are the predictors and consequences of postdischarge gastrointestinal bleeding in patients who underwent PCI?
Postdischarge gastrointestinal bleeding after PCI is relatively rare and not directly associated with MACCE, but it leads to DAPT cessation which significantly increases 2-year mortality.
Answers are grounded in this paper and cite their sources.
Gastrointestinal bleeding may prompt DAPT cessation after PCI; observational data leaves open its causal impact on outcomes.
AIM: To evaluate the incidence, predictors, and outcomes of postdischarge gastrointestinal bleeding (GIB) in patients underwent percutaneous coronary intervention (PCI) in a 2-year follow-up study. METHODS AND RESULTS: All consecutive patients who underwent PCI throughout 2013 were enrolled. Multivariable cox proportional hazards regression were used to identify predictors of postdischarge GIB and 2-year major adverse cardiovascular and cerebrovascular events (MACCE). Among 10 637 enrolled patients, postdischarge GIB events occurred in 123 (1.1%) patients at a median time of 329 days (interquartile range: 191-504 days). Predictor of postdischarge GIB included renal dysfunction and use of ticagrelor. There was no significant association between postdischarge GIB and MACCE (7.3% vs 12.0%, P = .092). Among whole population, 310 (2.91%) patients had dual antiplatelet therapy (DAPT) cessation. DAPT cessation was strongly associated with 2-year mortality (21.6% vs 0.4%, P < .001). CONCLUSION: In this large cohort of real-world patients after PCI, postdischarge GIB was not significantly associated with MACCE up to 2 years of follow-up but lead to an increase in DAPT cessation, and DAPT cessation was strongly associated with 2-year mortality.
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Zhu et al. (2018) conducted a cohort in Percutaneous coronary intervention (PCI) (n=10,637). Postdischarge gastrointestinal bleeding vs. No postdischarge gastrointestinal bleeding was evaluated on 2-year major adverse cardiovascular and cerebrovascular events (MACCE) (p=0.092). Postdischarge gastrointestinal bleeding after PCI was not significantly associated with 2-year MACCE (7.3% vs 12.0%, P=0.092) but led to an increase in DAPT cessation.
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