Decreased Serum Albumin Predicts Bleeding Events in Patients on Antiplatelet Therapy After Percutaneous Coronary Intervention.
Antiplatelet therapy (APT) after percutaneous coronary intervention (PCI) prevents ischemic events with increased risk of bleeding. Little is known about the relationship between hypoalbuminemia and bleeding risk in patients receiving APT after PCI. This study investigated the association between serum albumin level and bleeding events in this population.



We enrolled 438 consecutive patients who were prescribed dual APT (DAPT; aspirin and thienopyridine) beyond 1 month after successful PCI without adverse events. The patients were divided into 3 groups according to serum albumin tertile: tertile 1, ≤3.7 g/dL; tertile 2, 3.8-4.1 g/dL; and tertile 3, ≥4.2 g/dL. Adverse bleeding events were defined as Bleeding Academic Research Consortium criteria types 2, 3, and 5. During the median follow-up of 29.5 months, a total of 30 adverse bleeding events were observed. Median duration of DAPT was 14 months. The tertile 1 group had the highest risk of adverse bleeding events (event-free rate, 83.1%, 94.3% and 95.8%, respectively; P<0.001). On Cox proportional hazards modeling, serum albumin independently predicted adverse bleeding events (HR, 0.10, 95% CI: 0.027-0.39, P=0.001, for tertile 3 vs. tertile 1).



Decreased serum albumin predicted bleeding events in patients with APT after PCI.
Department of Cardiology, Nagoya University Graduate School of Medicine.
Yosuke
Y
Tatami
Department of Cardiology, Nagoya University Graduate School of Medicine.
Hideki
H
Ishii
Department of Cardiology, Nagoya University Graduate School of Medicine.
Toshijiro
T
Aoki
Department of Cardiology, Nagoya University Graduate School of Medicine.
Kazuhiro
K
Harada
Department of Cardiology, Nagoya University Graduate School of Medicine.
Kenshi
K
Hirayama
Department of Cardiology, Nagoya University Graduate School of Medicine.
Yohei
Y
Shibata
Department of Cardiology, Nagoya University Graduate School of Medicine.
Takuya
T
Sumi
Department of Cardiology, Nagoya University Graduate School of Medicine.
Yosuke
Y
Negishi
Department of Cardiology, Nagoya University Graduate School of Medicine.
Kazuhiro
K
Kawashima
Department of Cardiology, Nagoya University Graduate School of Medicine.
Ayako
A
Kunimura
Department of Cardiology, Nagoya University Graduate School of Medicine.
Toshiki
T
Kawamiya
Department of Cardiology, Nagoya University Graduate School of Medicine.
Dai
D
Yamamoto
Department of Cardiology, Nagoya University Graduate School of Medicine.
Susumu
S
Suzuki
Department of Cardiology, Nagoya University Graduate School of Medicine.
Toyoaki
T
Murohara
D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D000075462:Serum Albumin, Human / Q000378:metabolism*; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; C446540:thienopyridine; D001241:Aspirin; D000075462:Serum Albumin, Human
Albumin; Antiplatelet therapy; Bleeding event; Percutaneous coronary intervention