Related Experiment Video
Updated: Sep 13, 2025
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
5.2K
Decoding Bleeding Risks and Survival in Patients Undergoing Percutaneous Coronary Intervention on Antiplatelet
Chun-Chin Chang1, Andrew Kei-Yan Ng2, Norihiro Kogame3
1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
JACC. Asia
|July 30, 2025
Summary
Patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) face significant bleeding risks. High bleeding risk criteria identify nearly half of patients, highlighting the need for careful management to reduce mortality.
Area of Science:
- Cardiology
- Vascular Medicine
- Clinical Outcomes Research
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Percutaneous coronary intervention (PCI) is a common revascularization strategy for CAD.
- Antiplatelet therapy is crucial post-PCI but increases bleeding risk.
Purpose of the Study:
- To review bleeding risk and outcomes in patients with CAD undergoing PCI.
- To evaluate the prevalence and impact of bleeding events.
- To discuss risk stratification and management strategies for bleeding.
Main Methods:
- Comprehensive literature review of studies on bleeding risk and outcomes after PCI.
- Analysis of bleeding prevalence in clinical trials and real-world data.
- Evaluation of the Academic Research Consortium (ARC) for High Bleeding Risk criteria.
Main Results:
- Bleeding prevalence post-PCI ranges from 1-11%, significantly impacting mortality.
- Approximately 50% of patients meet criteria for high bleeding risk.
- Advanced age, chronic kidney disease, and comorbidities are key bleeding risk factors.
Conclusions:
- Bleeding is a major adverse event after PCI, strongly associated with increased mortality.
- Validated risk stratification tools, like the ARC criteria, are essential.
- Tailored management and vigilant monitoring are crucial for high-risk patients.
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
646
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
646
01:27Peripheral Artery Disease III: Interprofessional Care
29
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
29
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
44
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
44
01:28Acute Coronary Syndrome IV: Interprofessional Care
29
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
29
01:27Coronary Artery Disease V: Interprofessional Care
33
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
33
01:30Venous Thrombosis IV: Nursing Management
24
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
24