TY - JOUR
T1 - Decreased serum albumin predicts bleeding events in patients on antiplatelet therapy after percutaneous coronary intervention
AU - Tatami, Yosuke
AU - Ishii, Hideki
AU - Aoki, Toshijiro
AU - Harada, Kazuhiro
AU - Hirayama, Kenshi
AU - Shibata, Yohei
AU - Sumi, Takuya
AU - Negishi, Yosuke
AU - Kawashima, Kazuhiro
AU - Kunimura, Ayako
AU - Kawamiya, Toshiki
AU - Yamamoto, Dai
AU - Suzuki, Susumu
AU - Murohara, Toyoaki
N1 - Publisher Copyright:
© 2017, Japanese Circulation Society. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Background: Antiplatelet therapy (APT) after percutaneous coronary intervention (PCI) prevents ischemic events with increased risk of bleeding. Little is known about the relationship between hypoalbuminemia and bleeding risk in patients receiving APT after PCI. This study investigated the association between serum albumin level and bleeding events in this population. Methods and Results: We enrolled 438 consecutive patients who were prescribed dual APT (DAPT; aspirin and thienopyridine) beyond 1 month after successful PCI without adverse events. The patients were divided into 3 groups according to serum albumin tertile: tertile 1, ≤3.7 g/dL; tertile 2, 3.8-4.1 g/dL; and tertile 3, ≥4.2 g/dL. Adverse bleeding events were defined as Bleeding Academic Research Consortium criteria types 2, 3, and 5. During the median follow-up of 29.5 months, a total of 30 adverse bleeding events were observed. Median duration of DAPT was 14 months. The tertile 1 group had the highest risk of adverse bleeding events (eventfree rate, 83.1%, 94.3% and 95.8%, respectively; P<0.001). On Cox proportional hazards modeling, serum albumin independently predicted adverse bleeding events (HR, 0.10, 95% CI: 0.027-0.39, P=0.001, for tertile 3 vs. tertile 1).
AB - Background: Antiplatelet therapy (APT) after percutaneous coronary intervention (PCI) prevents ischemic events with increased risk of bleeding. Little is known about the relationship between hypoalbuminemia and bleeding risk in patients receiving APT after PCI. This study investigated the association between serum albumin level and bleeding events in this population. Methods and Results: We enrolled 438 consecutive patients who were prescribed dual APT (DAPT; aspirin and thienopyridine) beyond 1 month after successful PCI without adverse events. The patients were divided into 3 groups according to serum albumin tertile: tertile 1, ≤3.7 g/dL; tertile 2, 3.8-4.1 g/dL; and tertile 3, ≥4.2 g/dL. Adverse bleeding events were defined as Bleeding Academic Research Consortium criteria types 2, 3, and 5. During the median follow-up of 29.5 months, a total of 30 adverse bleeding events were observed. Median duration of DAPT was 14 months. The tertile 1 group had the highest risk of adverse bleeding events (eventfree rate, 83.1%, 94.3% and 95.8%, respectively; P<0.001). On Cox proportional hazards modeling, serum albumin independently predicted adverse bleeding events (HR, 0.10, 95% CI: 0.027-0.39, P=0.001, for tertile 3 vs. tertile 1).
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U2 - 10.1253/circj.CJ-17-0015
DO - 10.1253/circj.CJ-17-0015
M3 - Article
C2 - 28344205
AN - SCOPUS:85021435210
SN - 1346-9843
VL - 81
SP - 999
EP - 1005
JO - Circulation Journal
JF - Circulation Journal
IS - 7
ER -