Chang Chun-Chin, Ng Andrew Kei-Yan, Kogame Norihiro, Huang Po-Hsun, Kim Byeong-Keuk, van Geuns Robert-Jan M
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Gleneagles Hospital Hong Kong, Wong Chuk Hang, Hong Kong.
JACC Asia. 2025 Sep;5(9):1083-1094. doi: 10.1016/j.jacasi.2025.05.017. Epub 2025 Jul 29.
This comprehensive review focuses on bleeding risk and outcomes in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) with antiplatelet therapy. Bleeding prevalence varies widely, ranging from 1% to 10% in clinical trials and 2.8% to 11% in real-world studies, with a significant impact on mortality. The Academic Research Consortium for High Bleeding Risk criteria are well-validated, classifying approximately 50% of patients as high bleeding risk, who subsequently experience higher post-PCI bleeding rates. Key risk factors include advanced age, chronic kidney disease, and multiple comorbidities. This review also explores bleeding event definitions, risk stratification methods, and the clinical consequences of bleeding. The strong association between bleeding and mortality after PCI underscores the importance of vigilant monitoring and tailored management strategies.
本综述聚焦于接受经皮冠状动脉介入治疗（PCI）并使用抗血小板治疗的冠心病患者的出血风险及预后。出血发生率差异很大，在临床试验中为1%至10%，在真实世界研究中为2.8%至11%，对死亡率有显著影响。高出血风险学术研究联盟标准得到了充分验证，约50%的患者被归类为高出血风险，这些患者随后PCI后的出血率更高。关键风险因素包括高龄、慢性肾病和多种合并症。本综述还探讨了出血事件定义、风险分层方法以及出血的临床后果。PCI后出血与死亡率之间的强关联凸显了 vigilant监测和个性化管理策略的重要性。 （注：vigilant此处可能有误，推测可能是vigilant的正确形式vigilant，意为“警惕的” ）
