Gastrointestinal and Intracranial Bleeding Events after Second-Generation DES Implantation and Its Association with HBR, Predictors, and Clinical Outcomes

ARC-HBR was consistently associated with gastrointestinal bleeding (GIB) and intracranial bleeding (ICB) within 7 years, as reported by Dr. Yuya Taguchi of Kurashiki Central Hospital and his colleagues in the May issue of Circulation Journal.

To clarify the association with HBR, predictors, and clinical outcomes, this study examined GIB and ICB events at 7-year follow-up in 3,453 patients who underwent PCI with second-generation drug-eluting stents between 2010 and 2013.

The average follow-up was 2,663 days. The cumulative incidence of GIB and ICB was significantly higher in the HBR group than in the non-HBR group (6.3% vs 1.9%: p<0.001, 5.5% vs 2.3%: p<0.001). Older age, oral anticoagulants (OAC), and severe chronic kidney disease were independent predictors of GIB (HR 1.64 [95%CI 1.11-2.41] p=0.012: HR 1.94 [95%CI 1.23-3.05] p=0.004: HR 1.80 [95%CI 1.02-3.19] p=0.043), while low body weight, OAC, and left main coronary artery stenting were confirmed to be independent predictors of ICB by multivariate logistic regression analysis (HR 1.83 [95%CI 1.20-2.80] p=0.005: HR 2.04 [95%CI 1.31-3.19] p=0.002: HR 1.79 [95%CI 1.18-2.70] p=0.006).

Dr. Taguchi et al. summarized, “HBR based on ARC criteria showed a consistent association with GIB and ICB within a 7-year follow-up period. In addition, GIB and ICB each had three predictors, of which only OAC administration was common, while the other two were different.”

Taguchi Y, et al. Circ J. 2022; 86: 775-783

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