Jarrah Mohamad, Hammoudeh Ayman, Okkeh Osama, Khader Yousef, Gharaibeh Sahem, Nasser Laith, Rasheed Amro, Al-Hindi Ayed, Mohealdeen Mohammad, Kharabsheh Haneen, Abunimeh Hanan, Hijjih Enas, Tashman Lina, Omar Delia, Kufoof Nadeen
Division of Cardiology, Internal Medicine Department, King Abdullah University Hospital, Jordan University of Science and Technology; Irbid-Jordan.
Anatol J Cardiol. 2017 Jun;17(6):445-451. doi: 10.14744/AnatolJCardiol.2017.7530. Epub 2017 Mar 22.
Determine the incidence of major bleeding events, their risk factors, and their impact on prognosis in Jordanian patients undergoing percutaneous coronary intervention (PCI). Evaluate the ability of the CRUSADE bleeding risk score (BRS) to predict major bleeding.
Major bleeding events were defined according to the CRUSADE classification and their incidence was evaluated from hospital admission to one year of follow up. The CRUSADE bleeding risk score was calculated for each patient during the index admission. Incidence of major bleeding events was evaluated in each of the bleeding score quintiles. JoPCR1 is a prospective, observational, multicenter registry of consecutive patients who underwent PCI at 12 tertiary care centers in Jordan. A case report form was used to record data prospectively at hospital admission, at discharge, and at 1 and 12 months of follow-up.
The study included 2426 consecutive patients who underwent PCI. During the index hospitalization, major and minor bleeding events occurred in 0.95% and 2.6% of patients, respectively. Multivariate analysis showed that only two variables were significantly associated with major bleeding: female gender (OR=3.7; 95% CI 1.6, 8.5; p=0.002) and past history of cardiovascular disease (OR=2.6; 95% CI 1.1, 5.9; p=0.026). Patients who had in-hospital major bleeding events had higher cardiac mortality during index hospitalization (13.0% vs. 0.7%, p<0.005) and at one year of follow up (13.0% vs. 1.8%, p<0.005) compared to those who had no such events. Receiver operating characteristic curve analysis showed that the CRUSADE BRS has a high ability to predict major bleeding.
Major bleeding events were uncommon in this ME registry of a contemporary cohort of patients undergoing PCI but were associated with a higher mortality rate compared with those who did not have major bleeding events. CRUSADE BRS was highly predictive of the incidence of major bleeding events.
确定约旦接受经皮冠状动脉介入治疗（PCI）患者的大出血事件发生率、危险因素及其对预后的影响。评估CRUSADE出血风险评分（BRS）预测大出血的能力。
根据CRUSADE分类定义大出血事件，并从入院至随访一年评估其发生率。在首次入院期间为每位患者计算CRUSADE出血风险评分。在每个出血评分五分位数中评估大出血事件的发生率。JoPCR1是一项前瞻性、观察性、多中心登记研究，纳入了约旦12家三级医疗中心连续接受PCI的患者。使用病例报告表在入院时、出院时以及随访1个月和12个月时前瞻性记录数据。
该研究纳入了2426例连续接受PCI的患者。在首次住院期间，大出血和小出血事件分别发生在0.95%和2.6%的患者中。多变量分析显示，只有两个变量与大出血显著相关：女性（OR=3.7；95%CI 1.6，8.5；p=0.002）和心血管疾病既往史（OR=2.6；95%CI 1.1，5.9；p=0.026）。与无院内大出血事件的患者相比，发生院内大出血事件的患者在首次住院期间（13.0%对0.7%，p<0.005）和随访一年时（13.0%对1.8%，p<0.005）的心脏死亡率更高。受试者工作特征曲线分析表明，CRUSADE BRS具有较高的预测大出血的能力。
在这个当代接受PCI患者队列的中东登记研究中，大出血事件并不常见，但与无大出血事件的患者相比，其死亡率更高。CRUSADE BRS对大出血事件的发生率具有高度预测性。
