1. Risk of Postdischarge Bleeding From Dual Antiplatelet Therapy After Percutaneous Coronary Intervention Among US Black and White Adults
- Author
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Brittain Heindl, Stephen Clarkson, Vibhu Parcha, Chrisly Dillon, Renuka Narayan, Ebikere Usifo, William Hillegass, Marguerite R. Irvin, Pankaj Arora, Guihua Zhai, Mark Beasley, and Nita Limdi
- Subjects
incidence ,percutaneous coronary intervention ,platelet aggregation inhibitors ,prasugrel hydrochloride ,proportional hazards models ,prospective studies ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Dual antiplatelet therapy after percutaneous coronary intervention reduces myocardial infarctions but increases bleeding. The risk of bleeding may be higher among Black patients for unknown reasons. Bleeding risk scores have not been validated among Black patients. We assessed the difference in bleeding risk between Black and White patients along with the performance of the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Anti Platelet Therapy, Patterns of Nonadherence to Antiplatelet Regimens in Stented Patients, and Academic Research Consortium for High Bleeding Risk scores among both groups. Methods and Results This was a single‐center prospective study of patients who underwent percutaneous coronary intervention (2014–2019) and were followed for 1 year. The outcome was postdischarge Bleeding Academic Research Consortium 2 to 5 bleeding. Incidence rates were reported. Cox proportional hazards models measured the effect of self‐reported Black race on bleeding and determined the predictors of bleeding among 19 a priori variables. The 3 risk scores were assessed among Black and White patients separately using the Harrell concordance index. Of 1529 included patients, 342 (22.4%) self‐reported as being Black race. Unadjusted bleeding rates were 22.7 per 100 person‐years among Black patients versus 16.3 among White patients (hazard ratio, 1.41 [95% CI, 1.00–2.00], P=0.052). Predictors of bleeding were age, glomerular filtration rate
- Published
- 2022
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