Predictors of Major Bleeding Using CRUSADE Bleeding Score for Patients with STEMI Underwent Primary Percutaneous Coronary Intervention

초록

Purpose: The CRUSADE score was validated as a assessment tools to evaluate likelihood of major bleeding in non-ST-elevation acute myocardial infarction. Then, we aimed to assess the relationship between the major bleeding incidence and CRUSADE score in ST-elevation acute myocardial infarction (STEMI). Methods: The study subjects were 670 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PPCI) of INTESTELLAR registry. We calculated the CRUSADE risk score and classified into three risk groups (Low vs, Moderate vs. High risk groups). According to CRUSADE risk score, patients with a high to very high baseline risk of bleeding were defined as high risk and patients with a very low or low baseline bleeding risk were defined as low risk. Primary endpoint was major bleeding events defined as gastrointestinal bleeding and hemorrhagic stroke. Results: Of 670 patients, Average follow-up duration is 26.9 months. Low risk group was present in 244 patients (36.4%), moderate risk group was present in 183 patients (27.3%), and high risk group was consisted of 243 patients (36.2%). Event of major bleeding was observed in 17 patients (2.53%). As a primary endpoint, major bleeding events were significantly difference among three groups (Low vs. Moderate vs. High; 0.4 vs. 3.3 vs. 4.1 %, P=0.05). In Kaplan- Meier analysis, The CRUSADE risk score well discriminated occurrence of major bleeding event among three group (p=0.005). Conclusions:. The CRUSADE risk score was good assessment tools to predict future major bleeding event in STEMI underwent PPCI.