机构：[1]Bellvitge Hospital, Barcelona, Spain[2]Hospital Álvaro Cunqueiro, Vigo, Spain[3]Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands[4]San Giovanni Battista Molinette Hospital, Turin, Italy[5]NorthShore University Hospital, Chicago, Illinois, United States[6]Clinical Hospital, Santiago de Compostela, Spain[7]Libin Cardiovascular Institute of Alberta, Calgary, Canada[8]San Carlos Hospital, Madrid, Spain[9]Anzhen Hospital, Beijing, Japan首都医科大学附属安贞医院[10]University Patras Hospital, Patras, Greece[11]Kerckhoff Heart and Thorax Center, Frankfurt, Germany[12]University Graduate School of Medicine, Kyoto, Japan[13]University Clinical Hospital, Warsaw, Poland[14]Beijing Anzhen Hospital, Capital Medical University, Beijing, Japan首都医科大学附属安贞医院[15]Tokai University School of Medicine, Tokyo, Japan[16]Hospital Sao Rafael, Salvador, Brazil[17]University Graduate School of Medicine, Kanazawa, Japan[18]University Clinic of Cardiology, Skopje, Macedonia
Background A poor ability of recommended risk scores for predicting in-hospital bleeding has been reported in elderly patients with acute coronary syndromes (ACS). No study assessed the prediction of post-discharge bleeding in the elderly. The new BleeMACS score (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome), was designed to predict post-discharge bleeding in ACS patients. We aimed to assess the predictive ability of the BleeMACS score in elderly patients. Methods We assessed the incidence and characteristics of severe bleeding after discharge in ACS patients aged 75 years. Bleeding was defined as any intracranial bleeding or bleeding leading to hospitalization and/or red blood transfusion, occurring within the first year after discharge. We assessed the predictive ability of the BleeMACS score according to age by Fine-Gray proportional hazards regression analysis, calculating receiver-operating characteristic (ROC) curves and the area under the ROC curves (AUC). Results The BleeMACS registry included 15,401 patients of whom 3,376/15,401 (21.9%) were aged 75 years. Elderly patients were more commonly treated with clopidogrel and less often treated with ticagrelor or prasugrel. Of 3,376 elderly patients, 190 (5.6%) experienced post-discharge bleeding. The incidence of bleeding was moderately higher in elderly patients (hazard ratio [HR], 2.31, 95% confidence interval [CI], 1.92-2.77). The predictive ability of the BleeMACS score was moderately lower in elderly patients (AUC, 0.652 vs. 0.691, p =0.001). Conclusion Elderly patients with ACS had a significantly higher incidence of post-discharge bleeding. Despite a lower predictive ability in older patients, the BleeMACS score exhibited an acceptable performance in these patients.
通讯机构：[1]Bellvitge Hospital, Barcelona, Spain[*1]Coronary Care Unit, Cardiology Department, Hospital Universitari de Bellvitge, Feixa Llarga S/N, L’Hospitalet de Llobregat, Barcelona 08907, Spain
推荐引用方式(GB/T 7714)：
Garay Alberto,Ariza-Sole Albert,Formiga Francesc,et al.Prediction of Post-Discharge Bleeding in Elderly Patients with Acute Coronary Syndromes: Insights from the BleeMACS Registry[J].THROMBOSIS AND HAEMOSTASIS.2018,118(5):929-938.doi:10.1055/s-0038-1635259.
APA：
Garay, Alberto,Ariza-Sole, Albert,Formiga, Francesc,Raposeiras-Roubin, Sergio,Abu-Assi, Emad...&Cequier, Angel.(2018).Prediction of Post-Discharge Bleeding in Elderly Patients with Acute Coronary Syndromes: Insights from the BleeMACS Registry.THROMBOSIS AND HAEMOSTASIS,118,(5)
MLA：
Garay, Alberto,et al."Prediction of Post-Discharge Bleeding in Elderly Patients with Acute Coronary Syndromes: Insights from the BleeMACS Registry".THROMBOSIS AND HAEMOSTASIS 118..5(2018):929-938
医学