Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Coronary Intervention
Bleeding Outcomes After Percutaneous Coronary Intervention in the Past Two Decades in Japan　― From the CREDO-Kyoto Registry Cohort-2 and Cohort-3 ―
Masahiro Natsuaki, Takeshi Morimoto, Hiroki Shiomi, Ko Yamamoto, Kyohei Yamaji, Hirotoshi Watanabe, Takashi Uegaito, Mitsuo Matsuda, Toshihiro Tamura, Ryoji Taniguchi, Moriaki Inoko, Hiroshi Mabuchi, Teruki Takeda, Takenori Domei, Manabu Shirotani, Natsuhiko Ehara, Hiroshi Eizawa, Katsuhisa Ishii, Masaru Tanaka, Tsukasa Inada, Tomoya Onodera, Ryuzo Nawada, Eiji Shinoda, Miho Yamada, Takashi Yamamoto, Hiroshi Sakai, Mamoru Toyofuku, Takashi Tamura, Mamoru Takahashi, Tomohisa Tada, Hiroki Sakamoto, Takeshi Tada, Kazuhisa Kaneda, Shinji Miki, Takeshi Aoyama, Satoru Suwa, Yukihito Sato, Kenji Ando, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Takeshi Kimura, on behalf of the CREDO-Kyoto PCI/CABG Registry Cohort-Investigators
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Keywords: Coronary artery disease, High bleeding risk, Percutaneous coronary intervention
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Supplementary material

2022 Volume 86 Issue 5 Pages 748-759

Editorial (86-5 pp. 760-762)
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Abstract

Background: Optimal intensity is unclear for P2Y12receptor blocker therapy after percutaneous coronary intervention (PCI) in real-world clinical practice.

Methods and Results: From the CREDO-Kyoto Registry, the current study population consisted of 25,419 patients (Cohort-2: n=12,161 and Cohort-3: n=13,258) who underwent their first PCI. P2Y12receptor blocker therapies were reduced dose of ticlopidine (200 mg/day), and global dose of clopidogrel (75 mg/day) in 87.7% and 94.8% of patients in Cohort-2 and Cohort-3, respectively. Cumulative 3-year incidence of GUSTO moderate/severe bleeding was significantly higher in Cohort-3 than in Cohort-2 (12.1% and 9.0%, P<0.0001). After adjusting 17 demographic factors and 9 management factors potentially related to the bleeding events other than the type of P2Y12receptor blocker, the higher bleeding risk in Cohort-3 relative to Cohort-2 remained significant (hazard ratio (HR): 1.52 95% confidence interval (CI) 1.37–1.68, P<0.0001). Cohort-3 compared with Cohort-2 was not associated with lower adjusted risk for myocardial infarction/ischemic stroke (HR: 0.96, 95% CI: 0.87–1.06, P=0.44).

Conclusions: In this historical comparative study, Cohort-3 compared with Cohort-2 was associated with excess bleeding risk, which might be at least partly explained by the difference in P2Y12receptor blockers.

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© 2022, THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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