Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study

Progress in decreasing ischemic complications in acute coronary syndrome (ACS) has come at the expense of increased bleeding risk. We estimated the long-term, post-discharge incidence of serious bleeding, characterized bleeding type, and identified predictors of bleeding and its impact on mortality in an unselected cohort of patients with ACS. In this population-based study, we included 1379 patients identified with an ACS, 2010–2014. Serious bleeding was defined as intracranial hemorrhage (ICH), bleeding requiring hospital admission, or bleeding requiring transfusion or surgery. During a median 4.6-year follow-up, 85 patients had ≥ 1 serious bleed (cumulative incidence, 8.6%; 95% confidence interval (CI) 8.3–8.9). A subgroup of 557 patients, aged ≥ 75 years had a higher incidence (13.4%) than younger patients (6.0%). The most common bleeding site was gastrointestinal (51%), followed by ICH (27%). Sixteen percent had a recurrence. Risk factors for serious bleeding were age ≥ 75 years, lower baseline hemoglobin (Hb) value, previous hypertension or heart failure. Serious bleeding was associated with increased mortality. Bleeding after ACS was fairly frequent and the most common bleeding site was gastrointestinal. Older age, lower baseline Hb value, hypertension and heart failure predicted bleeding. Bleeding did independently predict mortality.

Ulvenstam, AndersUmeå universitet,Avdelningen för medicin(Swepub:umu)anul0039 (författare)
Irewall, Anna-LottaUmeå universitet,Avdelningen för medicin(Swepub:umu)anir0003 (författare)
Söderström, LarsUmeå universitet,Avdelningen för medicin (författare)
Mooe, ThomasUmeå universitet,Avdelningen för medicin(Swepub:umu)thmo0009 (författare)
Umeå universitetAvdelningen för medicin (creator_code:org_t)

Ingår i:Scientific Reports: Springer Science and Business Media LLC11:12045-2322

Av författaren/redakt...: Graipe, Anna, 19 ...; Ulvenstam, Ander ...; Irewall, Anna-Lo ...; Söderström, Lars; Mooe, Thomas

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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