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Diagnostic ability of Japanese version of high bleeding risk criteria for ischemic outcomes in patients with acute myocardial infarction

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Abstract

The Japanese version of high bleeding risk (J-HBR) criteria was domestically proposed to identify patients at HBR after percutaneous coronary intervention (PCI). The applicability of J-HBR on bleeding events has been validated, while whether J-HBR predicts ischemic events is uncertain. This bi-center registry included 904 patients with acute myocardial infarction (MI) undergoing primary PCI. Patients were stratified by the J-HBR major (1 point) and minor (0.5 point) criteria. Patients with J-HBR ≥ 1 point were diagnosed as having HBR. The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiovascular death, recurrent MI, and ischemic stroke, after discharge. Of the 904 patients, 451 (49.9%) had the J-HBR. The primary endpoint more frequently occurred in patients with J-HBR than in those without (10.9% vs. 4.9%, p < 0.001) during the median follow-up period of 522 days. Probability of MACE was progressively increased with the increase in the number of J-HBR major and minor criteria, in which severe anemia, severe chronic kidney disease, prior heart failure, peripheral artery disease, and prior ischemic stroke were identified as significant factors associated with MACE. In patients with acute MI undergoing PCI, the J-HBR criteria were predictive for ischemic outcomes after discharge, suggesting that the J-HBR criteria may be useful to identify patients at high bleeding and ischemic risks.

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References

  1. Mefford MT, Li BH, Qian L, Reading SR, Harrison TN, Scott RD, Cavendish JJ, Jacobsen SJ, Kanter MH, Woodward M, Reynolds K (2020) Sex-specific trends in acute myocardial infarction within an integrated healthcare network, 2000 through 2014. Circulation 141:509–519

    Article  PubMed  Google Scholar 

  2. Ozaki Y, Hara H, Onuma Y, Katagiri Y, Amano T, Kobayashi Y, Muramatsu T, Ishii H, Kozuma K, Tanaka N, Matsuo H, Uemura S, Kadota K, Hikichi Y, Tsujita K, Ako J, Nakagawa Y, Morino Y, Hamanaka I, Shiode N, Shite J, Honye J, Matsubara T, Kawai K, Igarashi Y, Okamura A, Ogawa T, Shibata Y, Tsuji T, Yajima J, Iwabuchi K, Komatsu N, Sugano T, Yamaki M, Yamada S, Hirase H, Miyashita Y, Yoshimachi F, Kobayashi M, Aoki J, Oda H, Katahira Y, Ueda K, Nishino M, Nakao K, Michishita I, Ueno T, Inohara T, Kohsaka S, Ismail TF, Serruys PW, Nakamura M, Yokoi H, Ikari Y, Task Force on Primary Percutaneous Coronary Intervention (PCI) of the Japanese Cardiovascular Interventional Therapeutics (CVIT) (2022) CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022. Cardiovasc Interv Ther 37:1–34

    Article  PubMed  PubMed Central  Google Scholar 

  3. Saito Y, Oyama K, Tsujita K, Yasuda S, Kobayashi Y (2023) Treatment strategies of acute myocardial infarction: updates on revascularization, pharmacological therapy, and beyond. J Cardiol 81:168–178

    Article  PubMed  Google Scholar 

  4. Simonsson M, Wallentin L, Alfredsson J, Erlinge D, HellströmÄngerud K, Hofmann R, Kellerth T, Lindhagen L, Ravn-Fischer A, Szummer K, Ueda P, Yndigegn T, Jernberg T (2020) Temporal trends in bleeding events in acute myocardial infarction: insights from the SWEDEHEART registry. Eur Heart J 41:833–843

    Article  PubMed  Google Scholar 

  5. Takeji Y, Shiomi H, Morimoto T, Yoshikawa Y, Taniguchi R, Mutsumura-Nakano Y, Yamamoto K, Yamaji K, Tazaki J, Kato ET, Watanabe H, Yamamoto E, Yamashita Y, Fuki M, Suwa S, Inoko M, Takeda T, Shirotani M, Ehara N, Ishii K, Inada T, Tamura T, Onodera T, Shinoda E, Yamamoto T, Watanabe H, Yaku H, Nakatsuma K, Sakamoto H, Ando K, Soga Y, Furukawa Y, Sato Y, Nakagawa Y, Kadota K, Komiya T, Minatoya K, Kimura T, CREDO-Kyoto AMI Registry Wave-1 and the CREDO-Kyoto AMI Registry Wave-2 Investigators (2021) Changes in demographics, clinical practices and long-term outcomes of patients with ST segment-elevation myocardial infarction who underwent coronary revascularisation in the past two decades: cohort study. BMJ Open 11:e043683

    Article  PubMed  PubMed Central  Google Scholar 

  6. Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, Cuisset T, Cutlip D, Eerdmans P, Eikelboom J, Farb A, Gibson CM, Gregson J, Haude M, James SK, Kim HS, Kimura T, Konishi A, Laschinger J, Leon MB, Magee PFA, Mitsutake Y, Mylotte D, Pocock S, Price MJ, Rao SV, Spitzer E, Stockbridge N, Valgimigli M, Varenne O, Windhoevel U, Yeh RW, Krucoff MW, Morice MC (2019) Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk. Eur Heart J 40:2632–2653

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Ueki Y, Bär S, Losdat S, Otsuka T, Zanchin C, Zanchin T, Gragnano F, Gargiulo G, Siontis GCM, Praz F, Lanz J, Hunziker L, Stortecky S, Pilgrim T, Heg D, Valgimigli M, Windecker S, Räber L (2020) Validation of the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria in patients undergoing percutaneous coronary intervention and comparison with contemporary bleeding risk scores. EuroIntervention 16:371–379

    Article  PubMed  Google Scholar 

  8. Saito Y, Kobayashi Y (2021) Academic research consortium definition of high bleeding risk in clinical practice - validation and beyond. Circ J 85:806–807

    Article  PubMed  Google Scholar 

  9. Nakamura M, Kimura K, Kimura T, Ishihara M, Otsuka F, Kozuma K, Kosuge M, Shinke T, Nakagawa Y, Natsuaki M, Yasuda S, Akasaka T, Kohsaka S, Haze K, Hirayama A (2020) JCS 2020 guideline focused update on antithrombotic therapy in patients with coronary artery disease. Circ J 84:831–865

    Article  PubMed  Google Scholar 

  10. Natsuaki M, Morimoto T, Shiomi H, Ehara N, Taniguchi R, Tamura T, Tada T, Suwa S, Kaneda K, Watanabe H, Tazaki J, Watanabe S, Yamamoto E, Saito N, Fuki M, Takeda T, Eizawa H, Shinoda E, Mabuchi H, Shirotani M, Uegaito T, Matsuda M, Takahashi M, Inoko M, Tamura T, Ishii K, Onodera T, Sakamoto H, Aoyama T, Sato Y, Ando K, Furukawa Y, Nakagawa Y, Kadota K, Kimura T, CREDO-Kyoto PCI/CABG Registry Cohort-3 Investigators (2021) Application of the modified high bleeding risk criteria for Japanese patients in an all-comers registry of percutaneous coronary intervention - from the CREDO-Kyoto registry cohort-3. Circ J 85:769–781

    Article  PubMed  CAS  Google Scholar 

  11. Takahashi K, Miura K, Shima Y, Okabe K, Ikuta A, Taguchi Y, Ohya M, Kubo S, Tada T, Tanaka H, Fuku Y, Kadota K (2022) Comparison of original and modified Academic Research Consortium for High Bleeding Risk definitions in real-world practice. J Cardiol 80:155–161

    Article  PubMed  Google Scholar 

  12. Sotomi Y, Hikoso S, Nakatani D, Suna S, Dohi T, Mizuno H, Okada K, Kida H, Oeun B, Sunaga A, Sato T, Kitamura T, Sakata Y, Sato H, Hori M, Komuro I, Sakata Y, Osaka Acute Coronary Insufficiency Study (OACIS) Group (2021) Prevalence of the Japanese high bleeding risk criteria and its prognostic significance for fatal bleeding in patients with acute myocardial infarction. Heart Vessels 36:1484–1495

    Article  PubMed  Google Scholar 

  13. Shimizu T, Sakuma Y, Kurosawa Y, Muto Y, Sato A, Abe S, Misaka T, Oikawa M, Yoshihisa A, Yamaki T, Nakazato K, Ishida T, Takeishi Y (2022) Validation of Japanese bleeding risk criteria in patients after percutaneous coronary intervention and comparison with contemporary bleeding risk criteria. Circ Rep 4:230–238

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kubota N, Ozaki K, Akiyama T, Washiyama Y, Yoneyama S, Okubo T, Ikegami R, Hoyano M, Yanagawa T, Tanabe N, Inomata T (2022) Correlation between the Japanese version of the high bleeding risk (J-HBR) criteria and the PRECISE-DAPT score, and optimal J-HBR cut-off score to predict major bleeding. Circ Rep 4:363–370

    Article  PubMed  PubMed Central  Google Scholar 

  15. Matsumoto T, Saito Y, Sato T, Yamashita D, Suzuki S, Saito K, Wakabayashi S, Kitahara H, Sano K, Kobayashi Y (2023) Validation of the domestic high bleeding risk criteria for Japanese patients with acute myocardial infarction. J Atheroscler Thromb 30:299–309

    Article  PubMed  Google Scholar 

  16. Yamaji K, Natsuaki M, Morimoto T, Ono K, Furukawa Y, Nakagawa Y, Kadota K, Ando K, Shirai S, Watanabe H, Shiomi H, Kimura T (2015) Long-term outcomes after coronary stent implantation in patients presenting with versus without acute myocardial infarction (an observation from coronary revascularization demonstrating outcome study-Kyoto registry cohort-2). Am J Cardiol 116:15–23

    Article  PubMed  Google Scholar 

  17. Matsumoto T, Saito Y, Yamashita D, Sato T, Wakabayashi S, Kitahara H, Sano K, Kobayashi Y (2021) Impact of active and historical cancer on short- and long-term outcomes in patients with acute myocardial infarction. Am J Cardiol 159:59–64

    Article  PubMed  Google Scholar 

  18. Suzuki S, Saito Y, Yamashita D, Matsumoto T, Sato T, Wakabayashi S, Kitahara H, Sano K, Kobayashi Y (2022) Clinical characteristics and prognosis of patients with no standard modifiable risk factors in acute myocardial infarction. Heart Lung Circ 31:1228–1233

    Article  PubMed  Google Scholar 

  19. Sato T, Saito Y, Suzuki S, Matsumoto T, Yamashita D, Saito K, Wakabayashi S, Kitahara H, Sano K, Kobayashi Y (2022) Prognostic factors of in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock. Life (Basel) 12:1672

    PubMed  Google Scholar 

  20. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD, Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction (2018) Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol 72:2231–2264

    Article  PubMed  Google Scholar 

  21. Natsuaki M, Sonoda S, Yoshioka G, Hongo H, Kaneko T, Kashiyama K, Yokoi K, Hikichi Y, Node K (2022) Antiplatelet therapy after percutaneous coronary intervention: current status and future perspectives. Cardiovasc Interv Ther 37:255–263

    Article  PubMed  Google Scholar 

  22. Saito Y, Kobayashi Y, Fujii K, Sonoda S, Tsujita K, Hibi K, Morino Y, Okura H, Ikari Y, Honye J (2022) Clinical expert consensus document on intravascular ultrasound from the Japanese Association of Cardiovascular Intervention and Therapeutics (2021). Cardiovasc Interv Ther 37:40–51

    Article  PubMed  Google Scholar 

  23. Sonoda S, Hibi K, Okura H, Fujii K, Node K, Kobayashi Y, Honye J (2023) Current clinical use of intravascular ultrasound imaging to guide percutaneous coronary interventions (update). Cardiovasc Interv Ther 38:1–7

    Article  PubMed  Google Scholar 

  24. Fujii K, Kubo T, Otake H, Nakazawa G, Sonoda S, Hibi K, Shinke T, Kobayashi Y, Ikari Y, Akasaka T (2022) Expert consensus statement for quantitative measurement and morphological assessment of optical coherence tomography: update 2022. Cardiovasc Interv Ther 37:248–254

    Article  PubMed  Google Scholar 

  25. Sakamoto K, Sato R, Tabata N, Ishii M, Yamashita T, Nagamatsu S, Motozato K, Yamanaga K, Hokimoto S, Sueta D, Araki S, Fujisue K, Arima Y, Takashio S, Fujimoto K, Shimomura H, Tsunoda R, Hirose T, Sato K, Kikuta K, Sakaino N, Nakamura S, Yamamoto N, Matsumura T, Kajiwara I, Tayama S, Sakamoto T, Nakao K, Oshima S, Yamamoto E, Kaikita K, Tsujita K, Kumamoto Intervention Conference Study (KICS) Investigators (2022) Temporal trends in coronary intervention strategies and the impact on one-year clinical events: data from a Japanese multi-center real-world cohort study. Cardiovasc Interv Ther 37:66–77

    Article  PubMed  Google Scholar 

  26. Garcia-Garcia HM, McFadden EP, Farb A, Mehran R, Stone GW, Spertus J, Onuma Y, Morel MA, van Es GA, Zuckerman B, Fearon WF, Taggart D, Kappetein AP, Krucoff MW, Vranckx P, Windecker S, Cutlip D, Serruys PW, Academic Research Consortium (2018) Standardized end point definitions for coronary intervention trials: the academic research consortium-2 consensus document. Eur Heart J 39:2192–2207

    Article  PubMed  Google Scholar 

  27. Baber U, Mehran R, Giustino G, Cohen DJ, Henry TD, Sartori S, Ariti C, Litherland C, Dangas G, Gibson CM, Krucoff MW, Moliterno DJ, Kirtane AJ, Stone GW, Colombo A, Chieffo A, Kini AS, Witzenbichler B, Weisz G, Steg PG, Pocock S (2016) Coronary thrombosis and major bleeding after PCI with drug-eluting stents: risk scores from PARIS. J Am Coll Cardiol 67:2224–2234

    Article  PubMed  Google Scholar 

  28. Natsuaki M, Morimoto T, Yamaji K, Watanabe H, Yoshikawa Y, Shiomi H, Nakagawa Y, Furukawa Y, Kadota K, Ando K, Akasaka T, Hanaoka KI, Kozuma K, Tanabe K, Morino Y, Muramatsu T, Kimura T, CREDO‐Kyoto PCI/CABG Registry Cohort 2, RESET, and NEXT trial investigators (2018) Prediction of thrombotic and bleeding events after percutaneous coronary intervention: CREDO-Kyoto thrombotic and bleeding risk scores. J Am Heart Assoc 7:e008708

    Article  PubMed  PubMed Central  Google Scholar 

  29. Levine GN, Jeong YH, Goto S, Anderson JL, Huo Y, Mega JL, Taubert K, Smith SC Jr (2014) Expert consensus document: World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI. Nat Rev Cardiol 11:597–606

    Article  PubMed  Google Scholar 

  30. Yamashita D, Saito Y, Sato T, Matsumoto T, Saito K, Wakabayashi S, Kitahara H, Sano K, Kobayashi Y (2022) Impact of PARIS and CREDO-Kyoto thrombotic and bleeding risk scores on clinical outcomes in patients with acute myocardial infarction. Circ J 86:622–629

    Article  PubMed  Google Scholar 

  31. Taguchi Y, Miura K, Shima Y, Okabe K, Ikuta A, Takahashi K, Osakada K, Takamatsu M, Ohya M, Shimada T, Kubo S, Tada T, Tanaka H, Fuku Y, Kadota K (2022) Gastrointestinal and intracranial bleeding events after second-generation drug-eluting stent implantation—their association with high bleeding risk, predictors, and clinical outcomes. Circ J 86:775–783

    Article  PubMed  Google Scholar 

  32. Chew DP, Hyun K, Morton E, Horsfall M, Hillis GS, Chow CK, Quinn S, D’Souza M, Yan AT, Gale CP, Goodman SG, Fox K, Brieger D (2021) Objective risk assessment vs standard care for acute coronary syndromes: a randomized clinical trial. JAMA Cardiol 6:304–313

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was supported by grants from Chiba Foundation for Health Promotion & Disease Prevention.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan

    Tadahiro Matsumoto, Yuichi Saito, Takanori Sato, Daichi Yamashita, Kan Saito, Hideki Kitahara & Yoshio Kobayashi

  2. Department of Cardiovascular Medicine, Eastern Chiba Medical Center, Togane, Japan

    Sakuramaru Suzuki, Shinichi Wakabayashi & Koichi Sano

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  1. Tadahiro Matsumoto
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  2. Yuichi Saito
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Correspondence to Yuichi Saito.

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Matsumoto, T., Saito, Y., Sato, T. et al. Diagnostic ability of Japanese version of high bleeding risk criteria for ischemic outcomes in patients with acute myocardial infarction. Heart Vessels 39, 1–9 (2024). https://doi.org/10.1007/s00380-023-02303-3

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