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Japanese high bleeding risk criteria status predicts low thrombogenicity and bleeding events in patients undergoing percutaneous coronary intervention

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Abstract

Although the Japanese high bleeding risk criteria (J-HBR) were established to predict bleeding risk in patients undergoing percutaneous coronary intervention (PCI), the thrombogenicity in the J-HBR status remains unknown. Here, we examined the relationships among J-HBR status, thrombogenicity and bleeding events. This study was a retrospective analysis of 300 consecutive patients who underwent PCI. Blood samples obtained on the day of PCI were used in the total thrombus-formation analysis system (T-TAS) to investigate the thrombus-formation area under the curve (AUC; PL18-AUC10 for platelet chip; AR10-AUC30 for atheroma chip). The J-HBR score was calculated by adding 1 point for any major criterion and 0.5 point for any minor criterion. We assigned patients to three groups based on J-HBR status: a J-HBR-negative group (n = 80), a low score J-HBR-positive group (positive/low, n = 109), and a high score J-HBR-positive group (positive/high, n = 111). The primary end point was the 1-year incidence of bleeding events defined by the Bleeding Academic Research Consortium types 2, 3, or 5. Both PL18-AUC10 and AR10-AUC30 levels were lower in the J-HBR-positive/high group than the negative group. Kaplan–Meier analysis showed worse 1-year bleeding event-free survival in the J-HBR-positive/high group compared with the negative group. In addition, both T-TAS levels in J-HBR positivity were lower in those with bleeding events than in those without bleeding events. In multivariate Cox regression analyses, the J-HBR-positive/high status was significantly associated with 1-year bleeding events. In conclusion, the J-HBR-positive/high status could reflect low thrombogenicity as measured by T-TAS and high bleeding risk in patients undergoing PCI.

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Acknowledgements

We thank K. Hosokawa and T. Ohnishi from the Research Institute, Fujimori Kogyo Co., Yokohama, Kanagawa, Japan, for their excellent technical support in operating the T-TAS®. We also thank all paramedical staff members and clinical secretaries for their kind support during this work.

Funding

This study was supported in part by grants-in-aid for Scientific Research (#15K09089 and #18K08110) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Arao Municipal Hospital, Arao, Japan

    Nobuhiro Nakanishi

  2. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Nobuhiro Nakanishi, Masanobu Ishii, Naoto Kuyama, Noriaki Tabata, Miwa Ito, Kenshi Yamanaga, Koichiro Fujisue, Tadashi Hoshiyama, Hisanori Kanazawa, Shinsuke Hanatani, Daisuke Sueta, Seiji Takashio, Yuichiro Arima, Satoshi Araki, Hiroki Usuku, Taishi Nakamura, Eiichiro Yamamoto, Hirofumi Soejima, Kenichi Matsushita & Kenichi Tsujita

  3. Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Koichi Kaikita

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  1. Nobuhiro Nakanishi
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Correspondence to Koichi Kaikita.

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Conflict of interest

Dr. Koichi Kaikita has received remuneration for lecturing from Bayer Yakuhin, Ltd., Daiichi-Sankyo Co., Ltd., Novartis Pharma AG., and Otsuka Pharmaceutical Co., Ltd.; trust research/joint research funds from SBI Pharmaceuticals Co., Ltd., Bayer Yakuhin, Ltd., and Daiichi-Sankyo Co., Ltd.; and scholarship funds from Abbott Medical Co., Ltd. Dr. Kenichi Tsujita has received remuneration for lecturing from Amgen Astellas BioPharma K.K., Bayer Yakuhin, Ltd., Bristol-Myers K.K., Daiichi Sankyo Co., Ltd., Kowa Pharmaceutical Co. Ltd., MSD K.K., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd., ITI Co., Ltd., trust research/joint research funds from Bristol-Myers K.K., Kowa Pharmaceutical Co. Ltd., and scholarship funds from Abbott Medical Japan L.L.C, Abbott Vascular Japan Co., Ltd., Boston Scientific Japan K.K., Cardinal Health Japan, Chugai Pharmaceutical Co, Ltd., Fides-one, Inc., Fukuda Denshi Co., Ltd., Japan Lifeline Co., Ltd., Kaneka Medix Co., Ltd., Medtronic Japan Co., Ltd., Mitsubishi Tanabe Pharma, NIHON KOHDEN CORPORATION, NIPRO CORPORATION, Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and TERUMO Co, Ltd.

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Nakanishi, N., Kaikita, K., Ishii, M. et al. Japanese high bleeding risk criteria status predicts low thrombogenicity and bleeding events in patients undergoing percutaneous coronary intervention. Cardiovasc Interv and Ther 38, 299–308 (2023). https://doi.org/10.1007/s12928-023-00920-3

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