Risk stratification for ischemic and bleeding events in patients using a potent P2Y12 inhibitor

초록

Background: Currently available risk scores assessing ischemia or bleeding risks were not developed for patients using a potent P2Y12 inhibitors. Methods: This study included 326 patients using a potent P2Y12 inhibitor (ticagrelor for 225 patients and prasugrel for 101 patients). We tested the predictive power of various risk scores and platelet reactivity unit (PRU).Results: During mean follow-up duration of 610 days, 28 (8.6%) ischemic events (a composite of death, myocardial infarction and stroke) and 8 (2.5%) bleeding events (BARC≥2) occurred. In the ROC curve analysis, the CRUSADE, GRACE, ACUITY, ACTION scores and PRU well predicted ischemic events (Table). However, none of these risk scores showed the adequate discriminant power to predict bleeding events (Table). For the prediction of net adverse events, the CRUSADE and GRACE scores and PRU were useful (Table).Conclusion: The currently available scales were reliable to predict ischemic events but not bleeds in patients using a potent P2Y12 inhibitor.