Evaluation of bleeding and thrombotic risks in elderly ACS patients after PCI:a subgroup analysis of the BRIC-ACS trial in the real-world setting
Li Dandan
Yu Yani
Tuo Xiaodan
Shan Dongkai
Wang Jingjing
Chen Yundai
Abstract：Objective To investigate the incidence and related influencing factors of bleeding,thrombosis,and net adverse clinical events(NACE)in elderly Chinese patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods This study is a post-hoc analysis of the Beijing Risk Intervention Clinical Study(BRIC Study).Patients with ACS who underwent PCI treatment at 30 tertiary hospitals nationwide from May 2014 to January 2016 and from November 2017 to April 2020 were consecutively enrolled.Patients were divided into an elderly group(age ≥ 65 years)and a control group,and the incidence rates of Bleeding Academic Research Consortium(BARC)≥ 2 bleeding,major adverse cardiovascular events(MACE),and NACE within one year after discharge were compared between the two groups.Cox regression analysis was performed to explore the risk factors for NACE in elderly patients.Results A total of 3 126 elderly patients and 4 405 control patients were included.The incidence of BARC ≥ 2 bleeding one year after PCI was 6.1％(n=190)in elderly ACS patients,which was comparable to the control group(n=225,5.1％)(x2=3.306,P=0.069).The incidence of MACE was 4.9％,significantly higher than that in the control group(1.8％)(x2=56.831,P=0.000).The incidence of NACE was also significantly increased(10.6％ vs.6.8％)(x2=33.999,P=0.000).Multivariate Cox regression analysis revealed that chronic renal insufficiency,clinical manifestations of myocardial infarction,and antithrombotic medication strategy were independent risk factors for NACE in elderly ACS patients(P＜0.05).Conclusion The incidence of MACE significantly increases in elderly Chinese ACS patients after PCI,and the incidence of NACE,considering BARC ≥ 2 bleeding,also significantly rises.Chronic renal insufficiency,clinical manifestations of myocardial infarction,and antithrombotic medication strategy are independent risk factors for NACE in elderly ACS patients one year after hospital discharge.
Keywords：Acute coronary syndromesPercutaneous coronary interventionElderlyBARC ≥ 2 bleedingMajor adverse cardiovascular eventsNet adverse clinical events
Publication Date：2025-04-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 281-285 )