Predictive Value of PARIS Bleeding Score on In-hospital Bleeding of Acute Myocardial Infarction Patients With Drug-eluting Stent Implantation
10.3969/j.issn.1000-3614.2018.02.003
- VernacularTitle:PARIS出血评分对急性心肌梗死药物支架术后患者院内出血的预测价值——中国急性心肌梗死注册研究
- Author:
Xue-Yan ZHAO
1
;
Jin-Gang YANG
;
Xiao-Xue FAN
;
Jun ZHANG
;
Yuan WU
;
Yang WANG
;
Hai-Yan XU
;
Xiao-Jin GAO
;
Ke-Fei DOU
;
Yi-Da TANG
;
Shu-Bin QIAO
;
Shu-Hong SU
;
Hong-Mei YANG
;
Xu-Xia ZHANG
;
Jin-Qing YUAN
;
Wei LI
;
Yue-Jin YANG
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 冠心病诊治中心
- Keywords:
PARIS bleeding score;
Myocardial infarction;
Drug-eluting stent
- From:
Chinese Circulation Journal
2018;33(2):110-116
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the predictive value of PARIS bleeding score on in-hospital bleeding of acute myocardial infarction (AMI) patients after drug-eluting stent (DES) implantation with dual-antiplatelet therapy (DAPT). Methods: There were 27 594 AMI patients enrolled in China acute myocardial infarction (CAMI) registry between 2013-01-01 to 2014-09-30 from 107 hospitals, and 14 625 of them had successful in-hospital DES implantation with DAPT were studied. Based on BARC (bleeding academic research consortium definition) criteria, the end point major bleeding (MB) events were defined by both BARC type 3, 5 and BARC type 2, 3, 5; the incidence of in-hospital bleeding, clinical features and predictive value of PARIS bleeding score according to different BARC type were evaluated. Results: Compared with non-MB patients, MB patients had the higher PARIS bleeding score, P<0.001. Based on PARIS score risk stratification, taking BARC type 3, 5 as endpoint, 77/14 625 (0.53%) patients had bleeding events, PARIS scores were different among high risk, mid risk and low risk patients, P<0.001; bleeding risk in mid risk patients was 2.38 times higher than low risk patients, P=0.006 and bleeding risk in high risk patients was 4.78 times higher than low risk patients, P<0.001.Taking BARC type 2,3,5 as endpoint,223(1.52%)patients had bleeding events,bleeding risk in mid risk patients was 1.64 times higher than low risk patients, P=0.002 and bleeding risk in high risk patients was 2.23 times higher than low risk patients, P=0.001. ROC analysis showed that PARIS score had predictive value on both BARC type 3, 5 and BARC type 2, 3, 5 bleeding, area under curve (AUC) of BARC type 3, 5 (AUC: 0.672) was higher than AUC of BARC type 2, 3, 5 (AUC:0.596) (z=2.079, P=0.038), which implied that PARIS score had better predictive value in severe bleeding events. Conclusion: PARIS bleeding score had predictive value on in-hospital bleeding in AMI patients after DES implantation with DAPT, it can also be used in bleeding risk stratification. PARIS bleeding score had better predictive value on severe bleeding.
