Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities
The Academic Research Consortium (ARC) recently published a definition of patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention. However, the prevalence of the ARC-HBR criteria in patients undergoing endovascular therapy (EVT) for peripheral artery disease in lower extre...
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| Veröffentlicht in: | Heart and vessels 2021-09, Vol.36 (9), p.1350-1358 |
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| creator | Hashimoto, Ryota Numasawa, Yohei Yokokura, Souichi Daigo, Kyohei Sakata, Shingo Imaeda, Shohei Hitomi, Yasuhiro Sato, Kazuki Taruoka, Akira Haginiwa, Sho Kojima, Hidenori Tanaka, Makoto Kuno, Toshiki Kodaira, Masaki |
| description | The Academic Research Consortium (ARC) recently published a definition of patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention. However, the prevalence of the ARC-HBR criteria in patients undergoing endovascular therapy (EVT) for peripheral artery disease in lower extremities has not been thoroughly investigated. This study sought to investigate the prevalence and impact of the ARC-HBR criteria in patients undergoing EVT. We analyzed 277 consecutive patients who underwent their first EVT from July 2011 to September 2019. We applied the full ARC-HBR criteria to the study population. The primary end point was a composite outcome of all-cause mortality, Bleeding Academic Research Consortium 3 or 5 bleeding, and lower limb amputation within 12 months of EVT. Among the 277 patients, 193 (69.7%) met the ARC-HBR criteria. HBR patients had worse clinical outcomes compared with non-HBR patients at 12 months after EVT, including a higher incidence of the composite primary outcome (19.2% vs. 3.6%,
p
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| doi_str_mv | 10.1007/s00380-021-01813-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2495401475</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2557850899</sourcerecordid><originalsourceid>FETCH-LOGICAL-c465t-c8d6ee6a43c5efd578074d7aef58be85f84eb5b804c4183bd195f5bea0c6f25c3</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EokvhBTggS1y4BOzYTpxjtSoUqRIIwdly7MmuS9YO46Swj8Rb1mELSBw4WSN_8_0j_YQ85-w1Z6x9kxkTmlWs5hXjmouqfkA2vOGqqlUrHpIN6zirtKjbM_Ik5xvGuOp495icCdEozoXckJ8fEW7tCNEBTQOd90AvnPVwCI5-ggwW3Z5uU8wJ57Ac6D7s9rQfAXyIO4ohf6UOwwwYLA2RTnYOEOdMl-gBd2mFIPp0a7NbRotrANrpSIeEdCpb0zqP1GJRHKkPJTHDahrTd0AKP2YstxRpfkoeDXbM8Oz-PSdf3l5-3l5V1x_evd9eXFdONmqunPYNQGOlcAoGr1rNWulbC4PSPWg1aAm96jWTTnItes87NageLHPNUCsnzsmrk3fC9G2BPJtDyA7G0UZISza17JRkXLaqoC__QW_SgrFcZ2pVkhXTXVeo-kQ5TDkjDGbCcLB4NJyZtUhzKtKUIs2vIk1dll7cq5f-AP7Pyu_mCiBOQC5fcQf4N_s_2jv5ma17</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2557850899</pqid></control><display><type>article</type><title>Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hashimoto, Ryota ; Numasawa, Yohei ; Yokokura, Souichi ; Daigo, Kyohei ; Sakata, Shingo ; Imaeda, Shohei ; Hitomi, Yasuhiro ; Sato, Kazuki ; Taruoka, Akira ; Haginiwa, Sho ; Kojima, Hidenori ; Tanaka, Makoto ; Kuno, Toshiki ; Kodaira, Masaki</creator><creatorcontrib>Hashimoto, Ryota ; Numasawa, Yohei ; Yokokura, Souichi ; Daigo, Kyohei ; Sakata, Shingo ; Imaeda, Shohei ; Hitomi, Yasuhiro ; Sato, Kazuki ; Taruoka, Akira ; Haginiwa, Sho ; Kojima, Hidenori ; Tanaka, Makoto ; Kuno, Toshiki ; Kodaira, Masaki</creatorcontrib><description>The Academic Research Consortium (ARC) recently published a definition of patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention. However, the prevalence of the ARC-HBR criteria in patients undergoing endovascular therapy (EVT) for peripheral artery disease in lower extremities has not been thoroughly investigated. This study sought to investigate the prevalence and impact of the ARC-HBR criteria in patients undergoing EVT. We analyzed 277 consecutive patients who underwent their first EVT from July 2011 to September 2019. We applied the full ARC-HBR criteria to the study population. The primary end point was a composite outcome of all-cause mortality, Bleeding Academic Research Consortium 3 or 5 bleeding, and lower limb amputation within 12 months of EVT. Among the 277 patients, 193 (69.7%) met the ARC-HBR criteria. HBR patients had worse clinical outcomes compared with non-HBR patients at 12 months after EVT, including a higher incidence of the composite primary outcome (19.2% vs. 3.6%,
p
< 0.001) and all-cause death (7.8% vs. 0%,
p
= 0.007). In a multivariate Cox proportional hazards regression analysis, presence of the ARC-HBR criteria [hazard ratio (HR) 4.15, 95% confidence interval (CI) 1.25–13.80,
p
= 0.020], body mass index (HR 1.13, 95% CI 1.01–1.27,
p
= 0.042), diabetes mellitus (HR 2.70, 95% CI 1.28–5.69,
p
= 0.009), hyperlipidemia (HR 0.41, 95% CI 0.21–0.80,
p
= 0.009), and infrapopliteal lesions (HR 3.51, 95% CI 1.63–7.56,
p
= 0.001) were independent predictors of the primary composite outcome. Approximately 70% of Japanese patients undergoing EVT met the ARC-HBR criteria, and its presence was strongly associated with adverse outcomes within 12 months of EVT.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-021-01813-2</identifier><identifier>PMID: 33651134</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Amputation ; Biomedical Engineering and Bioengineering ; Bleeding ; Body mass ; Body mass index ; Body size ; Cardiac Surgery ; Cardiology ; Cardiovascular system ; Confidence intervals ; Consortia ; Criteria ; Diabetes mellitus ; Extremities ; Health hazards ; Hemorrhage - epidemiology ; Hemorrhage - etiology ; Humans ; Hyperlipidemia ; Lower Extremity ; Medicine ; Medicine & Public Health ; Original Article ; Patients ; Percutaneous Coronary Intervention ; Peripheral Arterial Disease - diagnosis ; Peripheral Arterial Disease - epidemiology ; Peripheral Arterial Disease - surgery ; Platelet Aggregation Inhibitors ; Population studies ; Prevalence ; Regression analysis ; Risk Assessment ; Risk Factors ; Statistical analysis ; Treatment Outcome ; Vascular diseases ; Vascular Surgery</subject><ispartof>Heart and vessels, 2021-09, Vol.36 (9), p.1350-1358</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>2021. Springer Japan KK, part of Springer Nature.</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-c8d6ee6a43c5efd578074d7aef58be85f84eb5b804c4183bd195f5bea0c6f25c3</citedby><cites>FETCH-LOGICAL-c465t-c8d6ee6a43c5efd578074d7aef58be85f84eb5b804c4183bd195f5bea0c6f25c3</cites><orcidid>0000-0002-1739-2800</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-021-01813-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-021-01813-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33651134$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hashimoto, Ryota</creatorcontrib><creatorcontrib>Numasawa, Yohei</creatorcontrib><creatorcontrib>Yokokura, Souichi</creatorcontrib><creatorcontrib>Daigo, Kyohei</creatorcontrib><creatorcontrib>Sakata, Shingo</creatorcontrib><creatorcontrib>Imaeda, Shohei</creatorcontrib><creatorcontrib>Hitomi, Yasuhiro</creatorcontrib><creatorcontrib>Sato, Kazuki</creatorcontrib><creatorcontrib>Taruoka, Akira</creatorcontrib><creatorcontrib>Haginiwa, Sho</creatorcontrib><creatorcontrib>Kojima, Hidenori</creatorcontrib><creatorcontrib>Tanaka, Makoto</creatorcontrib><creatorcontrib>Kuno, Toshiki</creatorcontrib><creatorcontrib>Kodaira, Masaki</creatorcontrib><title>Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>The Academic Research Consortium (ARC) recently published a definition of patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention. However, the prevalence of the ARC-HBR criteria in patients undergoing endovascular therapy (EVT) for peripheral artery disease in lower extremities has not been thoroughly investigated. This study sought to investigate the prevalence and impact of the ARC-HBR criteria in patients undergoing EVT. We analyzed 277 consecutive patients who underwent their first EVT from July 2011 to September 2019. We applied the full ARC-HBR criteria to the study population. The primary end point was a composite outcome of all-cause mortality, Bleeding Academic Research Consortium 3 or 5 bleeding, and lower limb amputation within 12 months of EVT. Among the 277 patients, 193 (69.7%) met the ARC-HBR criteria. HBR patients had worse clinical outcomes compared with non-HBR patients at 12 months after EVT, including a higher incidence of the composite primary outcome (19.2% vs. 3.6%,
p
< 0.001) and all-cause death (7.8% vs. 0%,
p
= 0.007). In a multivariate Cox proportional hazards regression analysis, presence of the ARC-HBR criteria [hazard ratio (HR) 4.15, 95% confidence interval (CI) 1.25–13.80,
p
= 0.020], body mass index (HR 1.13, 95% CI 1.01–1.27,
p
= 0.042), diabetes mellitus (HR 2.70, 95% CI 1.28–5.69,
p
= 0.009), hyperlipidemia (HR 0.41, 95% CI 0.21–0.80,
p
= 0.009), and infrapopliteal lesions (HR 3.51, 95% CI 1.63–7.56,
p
= 0.001) were independent predictors of the primary composite outcome. Approximately 70% of Japanese patients undergoing EVT met the ARC-HBR criteria, and its presence was strongly associated with adverse outcomes within 12 months of EVT.</description><subject>Amputation</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Bleeding</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiovascular system</subject><subject>Confidence intervals</subject><subject>Consortia</subject><subject>Criteria</subject><subject>Diabetes mellitus</subject><subject>Extremities</subject><subject>Health hazards</subject><subject>Hemorrhage - epidemiology</subject><subject>Hemorrhage - etiology</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Lower Extremity</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention</subject><subject>Peripheral Arterial Disease - diagnosis</subject><subject>Peripheral Arterial Disease - epidemiology</subject><subject>Peripheral Arterial Disease - surgery</subject><subject>Platelet Aggregation Inhibitors</subject><subject>Population studies</subject><subject>Prevalence</subject><subject>Regression analysis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Treatment Outcome</subject><subject>Vascular diseases</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhBTggS1y4BOzYTpxjtSoUqRIIwdly7MmuS9YO46Swj8Rb1mELSBw4WSN_8_0j_YQ85-w1Z6x9kxkTmlWs5hXjmouqfkA2vOGqqlUrHpIN6zirtKjbM_Ik5xvGuOp495icCdEozoXckJ8fEW7tCNEBTQOd90AvnPVwCI5-ggwW3Z5uU8wJ57Ac6D7s9rQfAXyIO4ohf6UOwwwYLA2RTnYOEOdMl-gBd2mFIPp0a7NbRotrANrpSIeEdCpb0zqP1GJRHKkPJTHDahrTd0AKP2YstxRpfkoeDXbM8Oz-PSdf3l5-3l5V1x_evd9eXFdONmqunPYNQGOlcAoGr1rNWulbC4PSPWg1aAm96jWTTnItes87NageLHPNUCsnzsmrk3fC9G2BPJtDyA7G0UZISza17JRkXLaqoC__QW_SgrFcZ2pVkhXTXVeo-kQ5TDkjDGbCcLB4NJyZtUhzKtKUIs2vIk1dll7cq5f-AP7Pyu_mCiBOQC5fcQf4N_s_2jv5ma17</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Hashimoto, Ryota</creator><creator>Numasawa, Yohei</creator><creator>Yokokura, Souichi</creator><creator>Daigo, Kyohei</creator><creator>Sakata, Shingo</creator><creator>Imaeda, Shohei</creator><creator>Hitomi, Yasuhiro</creator><creator>Sato, Kazuki</creator><creator>Taruoka, Akira</creator><creator>Haginiwa, Sho</creator><creator>Kojima, Hidenori</creator><creator>Tanaka, Makoto</creator><creator>Kuno, Toshiki</creator><creator>Kodaira, Masaki</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1739-2800</orcidid></search><sort><creationdate>20210901</creationdate><title>Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities</title><author>Hashimoto, Ryota ; Numasawa, Yohei ; Yokokura, Souichi ; Daigo, Kyohei ; Sakata, Shingo ; Imaeda, Shohei ; Hitomi, Yasuhiro ; Sato, Kazuki ; Taruoka, Akira ; Haginiwa, Sho ; Kojima, Hidenori ; Tanaka, Makoto ; Kuno, Toshiki ; Kodaira, Masaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-c8d6ee6a43c5efd578074d7aef58be85f84eb5b804c4183bd195f5bea0c6f25c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Amputation</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Bleeding</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiovascular system</topic><topic>Confidence intervals</topic><topic>Consortia</topic><topic>Criteria</topic><topic>Diabetes mellitus</topic><topic>Extremities</topic><topic>Health hazards</topic><topic>Hemorrhage - epidemiology</topic><topic>Hemorrhage - etiology</topic><topic>Humans</topic><topic>Hyperlipidemia</topic><topic>Lower Extremity</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention</topic><topic>Peripheral Arterial Disease - diagnosis</topic><topic>Peripheral Arterial Disease - epidemiology</topic><topic>Peripheral Arterial Disease - surgery</topic><topic>Platelet Aggregation Inhibitors</topic><topic>Population studies</topic><topic>Prevalence</topic><topic>Regression analysis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Treatment Outcome</topic><topic>Vascular diseases</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hashimoto, Ryota</creatorcontrib><creatorcontrib>Numasawa, Yohei</creatorcontrib><creatorcontrib>Yokokura, Souichi</creatorcontrib><creatorcontrib>Daigo, Kyohei</creatorcontrib><creatorcontrib>Sakata, Shingo</creatorcontrib><creatorcontrib>Imaeda, Shohei</creatorcontrib><creatorcontrib>Hitomi, Yasuhiro</creatorcontrib><creatorcontrib>Sato, Kazuki</creatorcontrib><creatorcontrib>Taruoka, Akira</creatorcontrib><creatorcontrib>Haginiwa, Sho</creatorcontrib><creatorcontrib>Kojima, Hidenori</creatorcontrib><creatorcontrib>Tanaka, Makoto</creatorcontrib><creatorcontrib>Kuno, Toshiki</creatorcontrib><creatorcontrib>Kodaira, Masaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hashimoto, Ryota</au><au>Numasawa, Yohei</au><au>Yokokura, Souichi</au><au>Daigo, Kyohei</au><au>Sakata, Shingo</au><au>Imaeda, Shohei</au><au>Hitomi, Yasuhiro</au><au>Sato, Kazuki</au><au>Taruoka, Akira</au><au>Haginiwa, Sho</au><au>Kojima, Hidenori</au><au>Tanaka, Makoto</au><au>Kuno, Toshiki</au><au>Kodaira, Masaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>36</volume><issue>9</issue><spage>1350</spage><epage>1358</epage><pages>1350-1358</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>The Academic Research Consortium (ARC) recently published a definition of patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention. However, the prevalence of the ARC-HBR criteria in patients undergoing endovascular therapy (EVT) for peripheral artery disease in lower extremities has not been thoroughly investigated. This study sought to investigate the prevalence and impact of the ARC-HBR criteria in patients undergoing EVT. We analyzed 277 consecutive patients who underwent their first EVT from July 2011 to September 2019. We applied the full ARC-HBR criteria to the study population. The primary end point was a composite outcome of all-cause mortality, Bleeding Academic Research Consortium 3 or 5 bleeding, and lower limb amputation within 12 months of EVT. Among the 277 patients, 193 (69.7%) met the ARC-HBR criteria. HBR patients had worse clinical outcomes compared with non-HBR patients at 12 months after EVT, including a higher incidence of the composite primary outcome (19.2% vs. 3.6%,
p
< 0.001) and all-cause death (7.8% vs. 0%,
p
= 0.007). In a multivariate Cox proportional hazards regression analysis, presence of the ARC-HBR criteria [hazard ratio (HR) 4.15, 95% confidence interval (CI) 1.25–13.80,
p
= 0.020], body mass index (HR 1.13, 95% CI 1.01–1.27,
p
= 0.042), diabetes mellitus (HR 2.70, 95% CI 1.28–5.69,
p
= 0.009), hyperlipidemia (HR 0.41, 95% CI 0.21–0.80,
p
= 0.009), and infrapopliteal lesions (HR 3.51, 95% CI 1.63–7.56,
p
= 0.001) were independent predictors of the primary composite outcome. Approximately 70% of Japanese patients undergoing EVT met the ARC-HBR criteria, and its presence was strongly associated with adverse outcomes within 12 months of EVT.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>33651134</pmid><doi>10.1007/s00380-021-01813-2</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1739-2800</orcidid></addata></record> |
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| ispartof | Heart and vessels, 2021-09, Vol.36 (9), p.1350-1358 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Amputation Biomedical Engineering and Bioengineering Bleeding Body mass Body mass index Body size Cardiac Surgery Cardiology Cardiovascular system Confidence intervals Consortia Criteria Diabetes mellitus Extremities Health hazards Hemorrhage - epidemiology Hemorrhage - etiology Humans Hyperlipidemia Lower Extremity Medicine Medicine & Public Health Original Article Patients Percutaneous Coronary Intervention Peripheral Arterial Disease - diagnosis Peripheral Arterial Disease - epidemiology Peripheral Arterial Disease - surgery Platelet Aggregation Inhibitors Population studies Prevalence Regression analysis Risk Assessment Risk Factors Statistical analysis Treatment Outcome Vascular diseases Vascular Surgery |
| title | Prevalence of the Academic Research Consortium high bleeding risk criteria in patients undergoing endovascular therapy for peripheral artery disease in lower extremities |
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