所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||CREDO-Kyoto Score could Predict All-cause Mortality but not Thrombotic or Bleeding Event in Hemodialysis Patients after Coronary Intervention|
|発表者・共同発表者||◎田中一樹, 海老原卓, 大槻尚男, 中尾優, 重城健太郎, 山口淳一, 萩原誠久|
|概要||*Poster Session (Japanese)65 Coronary Revascularization/PCI (Restenosis/Others) 1
BACKGROUNDS: CREDO-Kyoto score has clinical benefits in predicting thrombotic and bleeding events after percutaneous coronary intervention (PCI). However, there has been little evidence on the efficacy of CREDO-Kyoto score on hemodialysis patients as the highest-risk population. METHODS: This observational study included 237 hemodialysis patients after PCI with drug eluting stent between 2010 and 2015. Patients with death, myocardial infarction (MI), stent thrombosis (ST), ischemic stroke, and bleeding events during the index hospitalization were excluded. During median observation period of 1,012 days, the incidences of death, thrombotic events (MI, ST, and ischemic stroke), and bleeding events were compared among patients in 3 categories of CREDO-Kyoto score at the time of PCI. RESULTS: This highest-risk population included no patient with Low-thrombotic or Low-bleeding CREDO-Kyoto score. Additionally, almost all patient (n=232, 97.9%) had High-bleeding score. In the thrombotic score category, High-score group (n=189) had significantly higher prevalence of patients with aged, diabetes, impaired left ventricular ejection fraction, atrial fibrillation, and peripheral artery disease (PAD), compared to Intermediate-score group (n=48). High-bleeding score group (n=232) included diabetic patients with PAD, and history of revascularization, compared to intermediate-bleeding score group (n=5). Kaplan-Meier analysis revealed that all-cause mortality was significantly higher in High-thrombotic score group than Intermediate-thrombotic score group (3-year mortality: 17.0% vs. 5.3%, p=0.023). In contrast, both rates of thrombotic and bleeding events were comparable between High- and Intermediate-score groups (3-year thrombotic events: 5.1% vs. 5.1%, p=0.85; bleeding events: 4.7% vs. 0%, p=0.67). CONCLUSION: CREDO-Kyoto score at baseline predicted long-term mortality, but did not predict thrombotic or bleeding events in hemodialysis patients after PCI.