Polypharmacy and Bleeding Outcomes After Percutaneous Coronary Intervention.

Area of Science:

• Cardiology
• Pharmacology
• Clinical Research

Background:

• Polypharmacy is linked to major bleeding in general populations.
• Data on polypharmacy and bleeding risk in percutaneous coronary intervention (PCI) patients were lacking.

Purpose of the Study:

• To investigate the association between the number of medications and major bleeding risk in patients undergoing PCI.
• To assess the impact of polypharmacy on both bleeding and ischemic events post-PCI.

Main Methods:

• Analysis of 12,291 patients from the CREDO-Kyoto PCI Registry Cohort-3.
• Medication counts at discharge were categorized into tertiles.
• Major bleeding (Bleeding Academic Research Consortium Type 3 or 5) incidence was compared across medication tertiles over 5 years.

Main Results:

• Approximately 90% of PCI patients used five or more medications.
• A significant, incremental increase in 5-year major bleeding risk was observed with higher medication counts.
• Adjusted analyses confirmed increased major bleeding risk for patients on 6-7 (HR 1.21) and ≥8 (HR 1.27) medications compared to ≤5.
• No significant association was found between medication count and the risk of myocardial infarction or ischemic stroke.

Conclusions:

• In real-world PCI patients, polypharmacy is common and associated with a significantly higher adjusted risk of major bleeding.
• The number of medications did not correlate with an increased risk of ischemic events like myocardial infarction or stroke.