Bleeding risk in patients with acute coronary syndrome in a Turkish population: Results from the Turkish Acute Coronary Syndrome Registry (TACSER) study

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 2 of 11 | AVCI et Al. How to cite this article: Avci E, Kiriş T, Akgün DE, et al. Bleeding risk in patients with acute coronary syndrome in a Turkish population: Results from the Turkish Acute Coronary Syndrome Registry (TACSER) study.

The role of risk scores for prediction of adverse events in patients undergoing PCI

“…To address this important subject, in this issue of the Journal, Avcı E. et al report their findings in this first step of a validation process of the PRECISE-DAPT score in a Turkish cohort by examining 963 ACS patients undergoing PCI. 5 The results indicate that in this Turkish ACS cohort, approximately 1/3 of patients had a PRECISE-DAPT score of ≥ 25, suggesting a significantly higher risk of out-of-hospital bleeding during DAPT. Importantly, the authors are encouraged to follow-up on this cohort and report on the actual bleeding events and their association with the calculated score, thereby completing the validation process of the PRECISE-DAPT score in this population.…”

Favorable factors for the survival of ST-segment elevation myocardial infarction patients with medium- and high-risk thrombolysis in myocardial infarction scores

“…TIMI scores combined with various clinical parameters could help health care professionals divide patients into different risk groups, adjust treatment strategies accordingly, and diminish the in-hospital mortality of STEMI patients. In a cohort study conducted in Turkey, TIMI bleeding scores along with Determining a patient’s Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) scores were used to conduct bleeding classification and evaluate bleeding risk in patients with acute coronary syndrome or those undergoing PCI [ 19 ]. Consistent with our finding, emergency PCI, a procedure used to restore blood flow to the blocked coronary arteries, has been identified as a significant favorable factor in patients with STEMI [ 20 ].…”