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Avci E, Kiriş T, Akgün DE, Celik A, Akçay FA, Acar B, Kurmuş Ö, Altındag R, Safak Ö, Demirtas AO, Güzel T, Öztürk Ö, Yildirim T, Yüksek U, Ergene AO. Bleeding risk in patients with acute coronary syndrome in a Turkish population: Results from the Turkish Acute Coronary Syndrome Registry (TACSER) study. Eur J Clin Invest 2020; 50:e13271. [PMID: 32592511 DOI: 10.1111/eci.13271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/16/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Bleeding is one of the most important causes of mortality in patients with acute coronary syndrome (ACS). This study therefore aimed to investigate bleeding risk in patients with ACS who were scheduled to receive dual antiplatelet therapy (DAPT) in Turkey. METHODS This was a multicentre, observational, cross-sectional cohort study. The study population included 963 patients with ACS from 12 centres in Turkey. We used the Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score to predict the bleeding risk for all the patients. The patients were divided into high (≥25) or low (˂25) bleeding risk groups based on their PRECISE-DAPT scores. RESULTS The mean PRECISE-DAPT score was 21.9. Overall, 32.2% of the patients had high PRECISE-DAPT scores (≥25). Compared with the male patients, the female patients had higher PRECISE-DAPT scores (28.2 ± 15.7 vs 18.4 ± 13.6, P ˂ .001). Among the females, the rate of patients with a PRECISE-DAPT score ≥25 was 53%, while among the male patients, the score occurred at a rate of 22%. The female patients had lower haemoglobin (Hb) levels than the male patients (12.1 ± 1.7 vs 13.8 ± 1.9, P ˂ .001) and lower creatinine clearance (70.7 ± 27.5 vs 88.7 ± 26.3, P ˂ .001). The in-hospital bleeding rates were higher among the patients with high PRECISE-DAPT scores than among those who did not have high scores. Furthermore, the patients with high PRECISE-DAPT scores had a higher in-hospital mortality rate compared with those with low PRECISE-DAPT scores (1% vs 0%, P = .11). CONCLUSIONS The mean PRECISE-DAPT score was high among the patients with ACS in this study, indicating that the bleeding tendency was high. This study showed that the PRECISE-DAPT score may help physicians determine the type and duration of DAPT, especially in patients with ACS in Turkey.
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Affiliation(s)
- Eyüp Avci
- Department of Cardiology, Medical School, Balikesir University, Balikesir, Turkey
| | - Tuncay Kiriş
- Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Didar Elif Akgün
- Department of Cardiology, Medical School, Balikesir University, Balikesir, Turkey
| | - Aykan Celik
- Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Filiz Akyildiz Akçay
- Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Burak Acar
- Department of Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Özge Kurmuş
- Department of Cardiolog, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Rojuva Altındag
- Department of Cardiology, Diyarbakır Gazi Yasargil Training and Research Hospital, Health Sciences University, Diyarbakır, Turkey
| | - Özgen Safak
- Department of Cardiology, Medical School, Balikesir University, Balikesir, Turkey
| | - Abdullah Orhan Demirtas
- Department of Cardiology, Adana Training and Research Hospital, Health Sciences University, Adana, Turkey
| | - Tuncay Güzel
- Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Önder Öztürk
- Department of Cardiology, Diyarbakır Gazi Yasargil Training and Research Hospital, Health Sciences University, Diyarbakır, Turkey
| | - Tarik Yildirim
- Department of Cardiology, Medical School, Balikesir University, Balikesir, Turkey
| | - Umit Yüksek
- Department of Cardiology, Faculty of Medicine, Near East University, Lefkoşa, Turkey
| | - Asim Oktay Ergene
- Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
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