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Shizhao Zhang

Chinese PLA General Hospital, China

Title: Related factors of bleeding events in ticagrelor-treated elderly patients with coronary artery disease

Biography

Biography: Shizhao Zhang

Abstract

Objective: To analyze the related factors of bleeding events in ticagrelor-treated elderly patients with coronary artery disease.

Method: Patients aged ≥ 65 years diagnosed with coronary artery disease and treated with ticagrelor were enrolled. All patients were followed up to observe the occurrence of Bleeding Academic Research Consortium (BARC) ≥ 2 requiring clinical intervention within 1 year. Patients were divided into bleeding group (n=55) and bleeding-free group (n=328) according to the occurrence of BARC ≥ 2 bleeding events. Multivariate regression analysis was applied to analyze the related factors of bleeding events during ticagrelor treatment 

Results: A total of 383 patients with coronary artery disease were recruited in this study, with 39 cases (10.18%) diagnosed with stable coronary artery disease, 344 cases (89.82%) diagnosed with the acute coronary syndrome and 37 cases (9.66%) received PCI. The serum level of hemoglobin and ratio of used β-blockers and calcium ion channel blocking agents were significantly lower while the platelet count, incidence of type 2 diabetes and ratio of used proton pump inhibitors were significantly higher in bleeding group than in bleeding free group. Among the eligible patients, 55 (14.36%) had BARC ≥ 2 bleeding events [Figure 1] and 10 patients (2.61%) had BARC ≥ 3 bleeding events during a 1-year follow-up. Gastrointestinal bleeding was the most common bleeding event (47.27%, n=26). Multivariate regression analysis found that decreased hemoglobin content (OR:0.98, 95% CI:0.96-1.00, P=0.02), type 2 diabetes (OR:2.46, 95% CI:1.29-4.69, P=0.01), application of proton pump inhibitors (OR:4.53, 95% CI:1.62-12.72, P<0.01) and application of β-blockers (OR:0.42, 95% CI:0.20-0.89, P=0.02) were independently associated with BARC ≥ 2 bleeding events [Table 2].

Conclusions: Hemoglobin, diabetes and concomitant medications are associated with the bleeding events in ticagrelor-treated elderly patients with coronary artery disease.