Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes

[eng] The incidence of acute coronary syndromes is high in the elderly population. Bleeding is associated with a poorer prognosis in this clinical setting. The available bleeding risk scores have not been validated specifically in the elderly. Our aim was to assess predictive ability of the most imp...

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Autores: Ariza Solé, Albert, Formiga Pérez, Francesc, Lorente, Victòria, Sánchez Salado, Jose Carlos, Sánchez Elvira, Guillermo, Roura Ferrer, Gerard, Sánchez Prieto, Remedios, Vila Sala, Maria, Moliner Borja, Pedro, Cequier Fillat, Àngel R.
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2014
País:España
Institución:Universidad de Oviedo (UNIOVI)
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/224861
Acceso en línea:https://hdl.handle.net/2445/224861
Access Level:acceso abierto
Palabra clave:Malalties coronàries
Persones grans
Coronary diseases
Older people
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network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
Eficacia de los scores de riesgo hemorrágico en el paciente anciano con síndrome coronario agudo
title Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
spellingShingle Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
Ariza Solé, Albert
Malalties coronàries
Persones grans
Coronary diseases
Older people
title_short Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
title_full Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
title_fullStr Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
title_full_unstemmed Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
title_sort Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary Syndromes
dc.creator.none.fl_str_mv Ariza Solé, Albert
Formiga Pérez, Francesc
Lorente, Victòria
Sánchez Salado, Jose Carlos
Sánchez Elvira, Guillermo
Roura Ferrer, Gerard
Sánchez Prieto, Remedios
Vila Sala, Maria
Moliner Borja, Pedro
Cequier Fillat, Àngel R.
author Ariza Solé, Albert
author_facet Ariza Solé, Albert
Formiga Pérez, Francesc
Lorente, Victòria
Sánchez Salado, Jose Carlos
Sánchez Elvira, Guillermo
Roura Ferrer, Gerard
Sánchez Prieto, Remedios
Vila Sala, Maria
Moliner Borja, Pedro
Cequier Fillat, Àngel R.
author_role author
author2 Formiga Pérez, Francesc
Lorente, Victòria
Sánchez Salado, Jose Carlos
Sánchez Elvira, Guillermo
Roura Ferrer, Gerard
Sánchez Prieto, Remedios
Vila Sala, Maria
Moliner Borja, Pedro
Cequier Fillat, Àngel R.
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malalties coronàries
Persones grans
Coronary diseases
Older people
topic Malalties coronàries
Persones grans
Coronary diseases
Older people
description [eng] The incidence of acute coronary syndromes is high in the elderly population. Bleeding is associated with a poorer prognosis in this clinical setting. The available bleeding risk scores have not been validated specifically in the elderly. Our aim was to assess predictive ability of the most important bleeding risk scores in patients with acute coronary syndrome aged >= 75 years. Methods: We prospectively included consecutive acute coronary syndromes patients. Baseline characteristics, laboratory findings, and hemodynamic data were collected. In-hospital bleeding was defined according to CRUSADE, Mehran, ACTION, and BARC definitions. CRUSADE, Mehran, and ACTION bleeding risk scores were calculated for each patient. The ability of these scores to predict major bleeding was assessed by binary logistic regression, receiver operating characteristic curves, and area under the curves. Results: We included 2036 patients, with mean age of 62.1 years; 369 patients (18.1%) were >= 75 years. Older patients had higher bleeding risk (CRUSADE, 42 vs 22; Mehran, 25 vs 15; ACTION, 36 vs 28; P<.001) and a slightly higher incidence of major bleeding events (CRUSADE bleeding, 5.1% vs 3.8%; P=.250). The predictive ability of these 3 scores was lower in the elderly (area under the curve, CRUSADE: 0.63 in older patients, 0.81 in young patients; P = .027; Mehran: 0.67 in older patients, 0.73 in younger patients; P = .340; ACTION: 0.58 in older patients, 0.75 in younger patients; P = .041). Conclusions: Current bleeding risk scores showed poorer predictive performance in elderly patients with acute coronary syndromes than in younger patients.
publishDate 2014
dc.date.none.fl_str_mv 2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/224861
url https://hdl.handle.net/2445/224861
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.rec.2013.10.008
Revista Española de Cardiologia, 2014, vol. 67, num.6, p. 463-470
https://doi.org/10.1016/j.rec.2013.10.008
dc.rights.none.fl_str_mv (c) Sociedad Española de Cardiología, 2014
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Sociedad Española de Cardiología, 2014
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier España
publisher.none.fl_str_mv Elsevier España
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Oviedo (UNIOVI)
instname_str Universidad de Oviedo (UNIOVI)
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Efficacy of Bleeding Risk Scores in Elderly Patients With Acute Coronary SyndromesEficacia de los scores de riesgo hemorrágico en el paciente anciano con síndrome coronario agudoAriza Solé, AlbertFormiga Pérez, FrancescLorente, VictòriaSánchez Salado, Jose CarlosSánchez Elvira, GuillermoRoura Ferrer, GerardSánchez Prieto, RemediosVila Sala, MariaMoliner Borja, PedroCequier Fillat, Àngel R.Malalties coronàriesPersones gransCoronary diseasesOlder people[eng] The incidence of acute coronary syndromes is high in the elderly population. Bleeding is associated with a poorer prognosis in this clinical setting. The available bleeding risk scores have not been validated specifically in the elderly. Our aim was to assess predictive ability of the most important bleeding risk scores in patients with acute coronary syndrome aged >= 75 years. Methods: We prospectively included consecutive acute coronary syndromes patients. Baseline characteristics, laboratory findings, and hemodynamic data were collected. In-hospital bleeding was defined according to CRUSADE, Mehran, ACTION, and BARC definitions. CRUSADE, Mehran, and ACTION bleeding risk scores were calculated for each patient. The ability of these scores to predict major bleeding was assessed by binary logistic regression, receiver operating characteristic curves, and area under the curves. Results: We included 2036 patients, with mean age of 62.1 years; 369 patients (18.1%) were >= 75 years. Older patients had higher bleeding risk (CRUSADE, 42 vs 22; Mehran, 25 vs 15; ACTION, 36 vs 28; P<.001) and a slightly higher incidence of major bleeding events (CRUSADE bleeding, 5.1% vs 3.8%; P=.250). The predictive ability of these 3 scores was lower in the elderly (area under the curve, CRUSADE: 0.63 in older patients, 0.81 in young patients; P = .027; Mehran: 0.67 in older patients, 0.73 in younger patients; P = .340; ACTION: 0.58 in older patients, 0.75 in younger patients; P = .041). Conclusions: Current bleeding risk scores showed poorer predictive performance in elderly patients with acute coronary syndromes than in younger patients.[spa] Introducción y objetivos La incidencia de síndrome coronario agudo en pacientes ancianos es elevada. Las complicaciones hemorrágicas empeoran el pronóstico en este escenario; a pesar de ello, los scores de riesgo hemorrágico disponibles no han sido validados específicamente en este subgrupo. Nuestro objetivo es analizar la capacidad predictiva de los principales scores de riesgo hemorrágico en pacientes de edad ≥ 75 años. Métodos Inclusión prospectiva de pacientes con síndrome coronario agudo consecutivos. Se registraron características basales, datos analíticos y hemodinámicos y la incidencia intrahospitalaria de hemorragias utilizando las definiciones CRUSADE, Mehran, ACTION y BARC. Se calcularon los scores CRUSADE, Mehran y ACTION de cada paciente y se analizó su capacidad predictiva de hemorragias mediante regresión logística binaria, cálculo de curvas receiver operating characteristic y áreas bajo la curva. Resultados Se incluyó a 2.036 pacientes con una media de edad de 62,1 años; el 18,1% (369 pacientes) era ≥ 75 o más años. Este subgrupo presentaba mayor riesgo hemorrágico (CRUSADE, 42 frente a 22; Mehran, 25 frente a 15; ACTION, 36 frente a 28; p < 0,001) y una incidencia de hemorragias mayores ligeramente superior (CRUSADE, el 5,1 frente al 3,8%; p = 0,250). La capacidad predictiva de los tres scores fue inferior en los ancianos (área bajo la curva, CRUSADE: ancianos, 0,63; jóvenes, 0,81; p = 0,027; Mehran: ancianos, 0,67; jóvenes, 0,73; p = 0,340; ACTION: ancianos, 0,58; jóvenes, 0,75; p = 0,041). Conclusiones Los scores de riesgo hemorrágico actualmente disponibles mostraron en el paciente anciano con síndrome coronario agudo un rendimiento claramente inferior al observado en pacientes más jóvenes.Elsevier España2014info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/224861Articles publicats en revistes (Ciències Clíniques)reponame:Dipòsit Digital de la UBinstname:Universidad de Oviedo (UNIOVI)InglésVersió postprint del document publicat a: https://doi.org/10.1016/j.rec.2013.10.008Revista Española de Cardiologia, 2014, vol. 67, num.6, p. 463-470https://doi.org/10.1016/j.rec.2013.10.008(c) Sociedad Española de Cardiología, 2014info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2248612026-05-27T06:46:51Z
score 15,811543

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