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

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.