Background Elderly patients with acute coronary syndromes (ACS) are at higher risk both for ischemic and bleeding complications.Current guidelines recommend the PRECISE-DAPT score for bleeding risk stratification in this setting,but no study assessed its applicability in elderly patients.This study aimed to assess the performance of the PRECISE-DAPT score in a series of non-selected elderly patients with ACS from routine clinical practice.Methods The IFFANIAM registry included prospectively patients aged ≥ 75 years with ST segment elevation myocardial infarction (STEMI).Main outcome measured was the incidence of relevant bleeding after discharge (bleeding leading to hospital readmission,need for transfusion,intervention,stop of antithrombotic drugs or death).Bleeding risk was classified:(A) according to PRECISE-DAPT values above or not the recommended cut-offpoint (≥ 25);and (B) according to the quartiles of PRECISE-DAPT values observed in the IFFANIAM series (Q1:< 30;Q2:30-35;Q3:36-44;Q4:≥ 45).Results A total of 208 patients were included.Mean age was 81.9 ± 4.5 years.Most patients (92.6%) had a PRECISE-DAPT value > 25.A total of 25 patients (12.0%) had bleeding events and 49 patients (23.6%) died.No significant differences regarding the incidence of bleeding were observed according to the recommended cutt of point ≥ 25.However,a progressive increase in the incidence of bleeding was observed across PRECISE-DAPT quartiles observed in this series (P =0.038).Conclusions The vast majority of elderly patients have PRECISE-DAPT values above the recommended cut-off point for bleeding risk.Using different cut-offpoints could be a more rational approach for predicting bleeding risk in these complex patients.
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机译:Effect of Baseline Thrombocytopenia on Long-Term Outcomes in Patients With Acute ST-Segment Elevated Myocardial Infarction ― A Large Propensity Score-Matching Analysis From the China Acute Myocardial Infarction (CAMI) Registry ―
机译:Retraction: Tanshinone IIA prevents left ventricular remodelling via the TLR4/MyD88/NF‐κB signalling pathway in rats with myocardial infarction. Dong‐Mei Wu Yong‐Jian Wang Xin‐Rui Han Xin Wen Lei Li Lan Xu Jun Lu and Yuan‐Lin Zheng. J Cell Mol Med. 2018; 22: 3058–3072 (https://doi.org/10.1111/jcmm.13557).