Refereed journal article or data article (A1)
High Bleeding Incidence in Unselected Hospitalized Suspected Non-ST-Segment Elevation Myocardial Infarction Patients Aged Under 65 Years
List of Authors: Kesti Henri, Mäkinen Henna, Mattila Kalle, Jaakkola Samuli, Lintu Mikko, Porela Pekka
Publisher: Elsevier
Publication year: 2023
Journal: American Journal of Cardiology
Journal name in source: The American journal of cardiology
Journal acronym: Am J Cardiol
Volume number: 206
Start page: 101
End page: 104
ISSN: 0002-9149
eISSN: 1879-1913
DOI: http://dx.doi.org/10.1016/j.amjcard.2023.08.102
URL: https://doi.org/10.1016/j.amjcard.2023.08.102
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/181114136
High bleeding risk (HBR) is commonly encountered among patients with acute coronary syndrome (ACS), and bleeding complications are associated with worse prognosis. Data on bleeding events of patients with ACS are based almost exclusively on percutaneous coronary intervention registries. Enrolling only patients suitable for invasive procedures might have skewed the observed bleeding incidence. We sought to investigate bleeding incidence in unselected patients with ACS. Patients were retrospectively enrolled between January and June 2019 from the emergency department of a tertiary hospital. All consecutive hospitalized adults with suspected non-ST-segment elevation myocardial infarction were included. Data was gathered by a database search and verified using electronic patient records. Bleeding risk was assessed according to the Academic Research Consortium for High Bleeding Risk (ARC-HBR) definition. The primary end point was a composite of post- discharge Bleeding Academic Research Consortium type 2, 3, and 5 bleeding during 1-year follow-up. Of the 209 included patients, 15 (7.2%) suffered a bleeding event. There were more bleeding events among dual antiplatelet therapy (DAPT) users as compared with those without DAPT (10.7% vs 3.1%, p = 0.033). Among HBR patients, 6.1% and in non-HBR patients 8.1% suffered a bleeding event (p = 0.579). Notably, major bleeding (Bleeding Academic Research Consortium type 3) incidence was highest in patients <65 years and without DAPT use. In conclusion, unselected suspected non-ST-segment elevation myocardial infarction patients aged <65 years had surprisingly high bleeding incidence, regardless of ARC-HBR status or DAPT use.
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