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Prognostic impact of peripheral artery disease in patients with and without high bleeding risk undergoing

Alessandro Spirito1, Rebecca Cohen1, Samantha Sartori1

  • 1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 5, 2024
PubMed

Insights

Peripheral artery disease (PAD) increases major adverse cardiac events (MACE) in high bleeding risk (HBR) patients after percutaneous coronary intervention (PCI). However, this association diminishes after adjusting for other health factors.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Peripheral artery disease (PAD) is linked to poorer outcomes following percutaneous coronary intervention (PCI).
  • Assessing the prognostic significance of PAD in patients with high bleeding risk (HBR) is crucial for risk stratification.

Purpose of the Study:

  • To evaluate the impact of PAD on major adverse cardiac events (MACE) and major bleeding in patients undergoing PCI.
  • To determine if PAD's prognostic value differs based on high bleeding risk (HBR) status.

Main Methods:

  • A cohort of 16,750 patients undergoing PCI with drug-eluting stents from 2012-2019 were analyzed.
  • Patients were stratified by high bleeding risk (HBR) and PAD status.
  • Outcomes included MACE (all-cause death, myocardial infarction, stroke) and major bleeding at 1 year post-PCI.

Main Results:

  • PAD patients, particularly within the HBR group, showed a higher risk of MACE (11.4% vs. 7.3%).
  • PAD was associated with a non-significant numerical increase in major bleeding among HBR patients.
  • Multivariable adjustment attenuated the association between PAD and adverse outcomes, regardless of HBR status.

Conclusions:

  • PAD is associated with increased MACE risk in HBR patients post-PCI, but this is largely explained by other risk factors.
  • After adjusting for comorbidities, PAD is not an independent predictor of adverse events in patients undergoing PCI.
Abstract

Keywords:
bleedinghigh bleeding riskoutcomespercutaneous coronary interventionperipheral artery disease

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