Kubota Naoki, Ozaki Kazuyuki, Akiyama Takumi, Washiyama Yuzo, Yoneyama Shintaro, Okubo Takeshi, Ikegami Ryutaro, Hoyano Makoto, Yanagawa Takao, Tanabe Naohito, Inomata Takayuki
Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences Niigata Japan.
Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture Niigata Japan.
Circ Rep. 2022 Jun 30;4(8):363-370. doi: 10.1253/circrep.CR-22-0059. eCollection 2022 Aug 10.
The correlation between the Japanese version of high bleeding risk (J-HBR) criteria and the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score is unknown, as is the relationship of both risk scores with ischemic events. This study enrolled 842 patients who underwent percutaneous coronary intervention (PCI) between January 2016 and December 2020. The 2 bleeding risk scores at the time of PCI and the subsequent risk of bleeding and ischemic events over a 1-year follow-up were examined. The J-HBR score was significantly correlated with the PRECISE-DAPT score (r=0.731, P<0.001). However, 1 year after PCI, the J-HBR was not significantly associated with the incidence of major bleeding and ischemic events (log-rank, P=0.058 and P=0.351, respectively), whereas the PRECISE-DAPT score predicted both the incidence of major bleeding and ischemic events (log-rank, P=0.006 and P=0.019, respectively). According to receiver operating characteristic curve analysis, a J-HBR score ≥1.5 was significantly associated with a higher cumulative incidence of major bleeding, but not ischemic events (log-rank, P=0.004 and P=0.513, respectively). The J-HBR score is highly correlated with the PRECISE-DAPT score. A J-HBR score ≥1.5 can identify high bleeding risk patients without an increased risk of ischemic events.
日本版高出血风险（J-HBR）标准与支架植入及后续双联抗血小板治疗患者出血并发症预测（PRECISE-DAPT）评分之间的相关性尚不清楚，这两种风险评分与缺血事件的关系也不明确。本研究纳入了2016年1月至2020年12月期间接受经皮冠状动脉介入治疗（PCI）的842例患者。研究了PCI时的2种出血风险评分以及随后1年随访期间的出血和缺血事件风险。J-HBR评分与PRECISE-DAPT评分显著相关（r=0.731，P<0.001）。然而，PCI术后1年，J-HBR与大出血和缺血事件的发生率无显著相关性（对数秩检验，P分别为0.058和0.351），而PRECISE-DAPT评分可预测大出血和缺血事件的发生率（对数秩检验，P分别为0.006和0.019）。根据受试者工作特征曲线分析，J-HBR评分≥1.5与大出血的累积发生率显著相关，但与缺血事件无关（对数秩检验，P分别为0.004和0.513）。J-HBR评分与PRECISE-DAPT评分高度相关。J-HBR评分≥1.5可识别出血风险高且缺血事件风险未增加的患者。
