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Erschienen in: Heart and Vessels 11/2017

30.05.2017 | Original Article

New scoring model (DARSYM score) to predict post-discharge bleeding after successful second-generation drug-eluting stent implantation

verfasst von: Yohsuke Honda, Masahiro Yamawaki, Keisuke Hirano, Motoharu Araki, Norihiro Kobayashi, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutumi, Takuro Takama, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito

Erschienen in: Heart and Vessels | Ausgabe 11/2017

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Abstract

We aimed to create a scoring model to predict post-discharge bleeding (PDB) after drug-eluting stent (DES) implantation in Japanese subjects. We enrolled 1912 consecutive patients undergoing DES implantation (age 70 ± 10 years; 72% male). PDB was defined as a composite of type 5, 3, and 2 bleeding using the Bleeding Academic Research Consortium criteria. A Cox proportional hazard model assessed predictors, and we then derived a clinical model stratifying risk of PDB after DES implantation. Ninety-eight patients (6.7%) experienced PDB; gastrointestinal bleeding (GIB) was most common (n = 66, 67%), followed by intracranial bleeding (n = 24, 25%). PDB was independently associated with age >80 years [risk ratio (RR): 1.89, p < 0.001], hypertension (RR: 1.68, p = 0.03), severe renal dysfunction (RR: 1.56, p = 0.04), anemia on admission (RR: 1.75, p = 0.02), prior history of GIB (RR: 3.49, p < 0.001), NSAIDs use (RR: 2.33, p = 0.03), and introduction of triple antithrombotic therapy (RR: 2.94, p < 0.001). A clinical prediction rule for risk of bleeding events including seven baseline factors was derived. A better predictive ability for PDB was found using this new scoring system than the HAS-BLED score [c statistics, 0.85 (95% CI 0.83–0.87) and c statistics, 0.71 (95% CI 0.69–0.73), respectively; p < 0.001]. This new scoring system including patient characteristics and laboratory variables can identify patients at high risk of PDB after DES implantation.
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Metadaten
Titel
New scoring model (DARSYM score) to predict post-discharge bleeding after successful second-generation drug-eluting stent implantation
verfasst von
Yohsuke Honda
Masahiro Yamawaki
Keisuke Hirano
Motoharu Araki
Norihiro Kobayashi
Yasunari Sakamoto
Shinsuke Mori
Masakazu Tsutumi
Takuro Takama
Takahiro Tokuda
Kenji Makino
Shigemitsu Shirai
Yoshiaki Ito
Publikationsdatum
30.05.2017
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 11/2017
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-017-1000-9

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