High bleeding risk ups ischaemic, thrombotic event risk after PCI

High bleeding risk (HBR) is common among patients after percutaneous coronary intervention (PCI) and may in turn increase the likelihood of ischaemic/thrombotic events, a recent sub-analysis of MODEL U-SES study has found.

Researchers retrospectively assessed 1,695 patients who had taken part in the multicentre, open-label, prospective observation MODEL U-SES study. Of the participants, 840 were deemed to have HBR after PCI, while 855 were not. Outcomes included ischaemic/thrombotic events—including cardiovascular death, myocardial infarction, ischaemic stroke, and stent thrombosis—and bleeding events at 1 year.

At follow-up, 1,616 (95.3 percent) provided eligible data, in which the cumulative incidence of ischaemic/thrombotic events was found to be 1.8 percent (n=31). Bleeding occurred in 21 patients, yielding an incidence rate of 1.2 percent.

Kaplan-Meier curves showed that ischaemic/thrombotic events occurred significantly more frequently in HBR patients (3.3 percent vs 0.6 percent; log-rank p<0.001), corresponding to a significant inverse probability of treatment weighting (IPTW)-adjusted risk estimate (hazard ratio [HR], 0.16, 95 percent confidence interval [CI], 0.05–0.50).

In particular, ischaemic stroke was significantly elevated in the HBR group, which likely drove the overall association (1.5 percent vs 0.1 percent; p=0.003).

On the other hand, bleeding events was only marginally more frequent in the HBR group, yielding a risk estimate that was only numerical in significance (1.8 percent vs 0.9 percent; log-rank p=0.109; IPTW-adjusted HR, 0.46, 95 percent CI, 0.17–1.28).