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首页> 外文期刊>EBioMedicine >CRUSADE Score is Superior to Platelet Function Testing for Prediction of Bleeding in Patients Following Coronary Interventions
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CRUSADE Score is Superior to Platelet Function Testing for Prediction of Bleeding in Patients Following Coronary Interventions

机译：CRUSADE评分优于血小板功能测试，可预测冠状动脉介入治疗后患者的出血

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Hypothetically, diminished platelet reactivity (PR) during dual antiplatelet therapy (DAPT) should cause extra major bleeding events (MBE), although definite evidence is lacking. Multiple scores have been proposed to stratify bleeding risk, but their predictive value during DAPT is unclear. We compared the performance of the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) with PR testing to predict MBE in Korean patients with acute coronary syndrome. We screened 1105, and included 903 consecutive patients who underwent coronary interventions. All patients received DAPT, while MBE were assessed by BARC scale. Admission platelet reactivity was assessed with VerifyNow Analyzer simultaneously with CRUSADE score, and MBE were collected at 1month and at 1year post stenting. There were a total of 113 (11%) MBE at 1month, and extra 41(5%) MBE at 1year. At 1month MBE prediction was superior by CRUSADE score (AUC: 0.816, 95% CI: 0.79 0.84, p<0.0001), compared to PR (AUC: 0.605, 95% CI: 0.572-0.637, p=0.0007). Moreover, CRUSADE score remains the independent predictor of MBE by multivariate analyses (OR=2.94, 95% CI: 2.18-3.96, p<0.0001). At 1year MBE also correlated, but were not significantly different between admission CRUSADE score (AUC: 0.62, 95% CI: 0.58 0.66, p=0.0183) and PR (AUC: 0.674, 95% CI: 0.63-0.71, p=0.002). We conclude that MBE are more common in real life than reported in clinical trials. CRUSADE score was superior to PR testing for predicting short-term, but not 1year MBE in Korean patients undergoing percutaneous coronary intervention and treated with DAPT.
机译：从理论上讲，尽管缺乏确凿的证据，但双重抗血小板治疗（DAPT）期间血小板反应性（PR）降低应引起额外的大出血事件（MBE）。已经提出了多个评分来对出血风险进行分层，但是尚不清楚在DAPT期间它们的预测价值。我们比较了将不稳定心绞痛患者的Can Can快速风险分层与早期实施ACC ​​/ AHA指南（CRUSADE）与PR测试相结合，以预测韩国急性冠脉综合征患者MBE的表现，以抑制不良后果。我们筛选了1105例患者，包括903例接受冠状动脉介入治疗的连续患者。所有患者均接受DAPT，而MBE通过BARC量表评估。同时使用VerifyNow Analyzer和CRUSADE评分评估入院血小板反应性，并在置入支架后1个月和1年收集MBE。 1个月时总共有113（11％）MBE，1年时又有41（5％）MBE。与PR（AUC：0.605，95％CI：0.572-0.637，p = 0.0007）相比，在1个月时MBE预测的CRUSADE评分更高（AUC：0.816，95％CI：0.79 0.84，p <0.0001）。此外，通过多变量分析，CRUSADE评分仍是MBE的独立预测因子（OR = 2.94，95％CI：2.18-3.96，p <0.0001）。在1年时，MBE也相关，但入院CRUSADE评分（AUC：0.62，95％CI：0.58 0.66，p = 0.0183）和PR（AUC：0.674，95％CI：0.63-0.71，p = 0.002）之间没有显着差异。 。我们得出结论，MBE在现实生活中比在临床试验中报告的更为普遍。对于接受经皮冠状动脉介入治疗并接受DAPT治疗的韩国患者，CRUSADE评分在预测短期但不是1年MBE方面优于PR测试。

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