Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study

Abstract Progress in decreasing ischemic complications in acute coronary syndrome (ACS) has come at the expense of increased bleeding risk. We estimated the long-term, post-discharge incidence of serious bleeding, characterized bleeding type, and identified predictors of bleeding and its impact on m...

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Autores principales:	Anna Graipe, Anders Ulvenstam, Anna-Lotta Irevall, Lars Söderström, Thomas Mooe
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8f2457971fa546ce8dbe60563824d3c6
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spelling	oai:doaj.org-article:8f2457971fa546ce8dbe60563824d3c62021-11-14T12:22:15ZIncidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study10.1038/s41598-021-01525-72045-2322https://doaj.org/article/8f2457971fa546ce8dbe60563824d3c62021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01525-7https://doaj.org/toc/2045-2322Abstract Progress in decreasing ischemic complications in acute coronary syndrome (ACS) has come at the expense of increased bleeding risk. We estimated the long-term, post-discharge incidence of serious bleeding, characterized bleeding type, and identified predictors of bleeding and its impact on mortality in an unselected cohort of patients with ACS. In this population-based study, we included 1379 patients identified with an ACS, 2010–2014. Serious bleeding was defined as intracranial hemorrhage (ICH), bleeding requiring hospital admission, or bleeding requiring transfusion or surgery. During a median 4.6-year follow-up, 85 patients had ≥ 1 serious bleed (cumulative incidence, 8.6%; 95% confidence interval (CI) 8.3–8.9). A subgroup of 557 patients, aged ≥ 75 years had a higher incidence (13.4%) than younger patients (6.0%). The most common bleeding site was gastrointestinal (51%), followed by ICH (27%). Sixteen percent had a recurrence. Risk factors for serious bleeding were age ≥ 75 years, lower baseline hemoglobin (Hb) value, previous hypertension or heart failure. Serious bleeding was associated with increased mortality. Bleeding after ACS was fairly frequent and the most common bleeding site was gastrointestinal. Older age, lower baseline Hb value, hypertension and heart failure predicted bleeding. Bleeding did independently predict mortality.Anna GraipeAnders UlvenstamAnna-Lotta IrevallLars SöderströmThomas MooeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anna Graipe Anders Ulvenstam Anna-Lotta Irevall Lars Söderström Thomas Mooe Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
description	Abstract Progress in decreasing ischemic complications in acute coronary syndrome (ACS) has come at the expense of increased bleeding risk. We estimated the long-term, post-discharge incidence of serious bleeding, characterized bleeding type, and identified predictors of bleeding and its impact on mortality in an unselected cohort of patients with ACS. In this population-based study, we included 1379 patients identified with an ACS, 2010–2014. Serious bleeding was defined as intracranial hemorrhage (ICH), bleeding requiring hospital admission, or bleeding requiring transfusion or surgery. During a median 4.6-year follow-up, 85 patients had ≥ 1 serious bleed (cumulative incidence, 8.6%; 95% confidence interval (CI) 8.3–8.9). A subgroup of 557 patients, aged ≥ 75 years had a higher incidence (13.4%) than younger patients (6.0%). The most common bleeding site was gastrointestinal (51%), followed by ICH (27%). Sixteen percent had a recurrence. Risk factors for serious bleeding were age ≥ 75 years, lower baseline hemoglobin (Hb) value, previous hypertension or heart failure. Serious bleeding was associated with increased mortality. Bleeding after ACS was fairly frequent and the most common bleeding site was gastrointestinal. Older age, lower baseline Hb value, hypertension and heart failure predicted bleeding. Bleeding did independently predict mortality.
format	article
author	Anna Graipe Anders Ulvenstam Anna-Lotta Irevall Lars Söderström Thomas Mooe
author_facet	Anna Graipe Anders Ulvenstam Anna-Lotta Irevall Lars Söderström Thomas Mooe
author_sort	Anna Graipe
title	Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
title_short	Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
title_full	Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
title_fullStr	Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
title_full_unstemmed	Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
title_sort	incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8f2457971fa546ce8dbe60563824d3c6
work_keys_str_mv	AT annagraipe incidenceandpredictorsofseriousbleedingduringlongtermfollowupafteracutecoronarysyndromeinapopulationbasedcohortstudy AT andersulvenstam incidenceandpredictorsofseriousbleedingduringlongtermfollowupafteracutecoronarysyndromeinapopulationbasedcohortstudy AT annalottairevall incidenceandpredictorsofseriousbleedingduringlongtermfollowupafteracutecoronarysyndromeinapopulationbasedcohortstudy AT larssoderstrom incidenceandpredictorsofseriousbleedingduringlongtermfollowupafteracutecoronarysyndromeinapopulationbasedcohortstudy AT thomasmooe incidenceandpredictorsofseriousbleedingduringlongtermfollowupafteracutecoronarysyndromeinapopulationbasedcohortstudy
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Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study

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