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Published on: May 14, 2013
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Application of the Academic Research Consortium High Bleeding Risk criteria in patients treated with coronary
Antonio Popolo Rubbio1, Luca Testa1, Carlo A Pivato2
1IRCCS Policlinico San Donato, Department of Clinical and Interventional Cardiology, San Donato Milanese, Milan, Italy.
Summary
Short dual antiplatelet therapy (S-DAPT) after Synergy EES PCI is safe and effective for high bleeding risk patients. The POEM trial confirms positive outcomes for both ischemic and bleeding events in this population.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- Short dual antiplatelet therapy (S-DAPT) is explored to minimize bleeding post-percutaneous coronary intervention (PCI).
- Modern drug-eluting stents (DES) offer improved safety profiles.
- High bleeding risk (HBR) patients require tailored antiplatelet strategies.
Purpose of the Study:
- To evaluate cardiovascular outcomes in HBR patients undergoing PCI with Synergy bioresorbable-polymer everolimus-eluting stents (EES).
- To assess outcomes based on the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria.
Main Methods:
- Analysis of the prospective, single-arm, multicenter POEM trial cohort.
- Application of ARC-HBR criteria to identify HBR patients.
- Primary endpoint: composite of cardiac death, myocardial infarction, or stent thrombosis at 12 months.
Main Results:
- The POEM cohort included 356 patients meeting ARC-HBR criteria.
- Oral anticoagulant use and age ≥75 years were common HBR indicators.
- The primary endpoint occurred in 5.2% of patients; major bleeding (ARC type 3-5) occurred in 2.7%.
Conclusions:
- S-DAPT with Synergy EES demonstrates favorable ischemic and bleeding outcomes in HBR patients.
- Subgroup analysis confirms the efficacy and safety of this strategy in the ARC-HBR population.
- The POEM trial results support S-DAPT for HBR patients treated with Synergy EES.
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