TY - JOUR
T1 - Higher Risk of Bleeding in Asians Presenting With ST-Segment Elevation Myocardial Infarction
T2 - Analysis of the National Inpatient Sample Database
AU - Misumida, Naoki
AU - Ogunbayo, Gbolahan O.
AU - Kim, Sun Moon
AU - Olorunfemi, Odunayo
AU - Elbadawi, Ayman
AU - Charnigo, Richard J.
AU - Abdel-Latif, Ahmed
AU - Ziada, Khaled M.
N1 - Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Bleeding is a major complication in patients presenting with ST-segment elevation myocardial infarction (STEMI). Several studies suggested that Asians are more susceptible to bleeding when treated with antiplatelets, anticoagulants, and thrombolytic agents. In our study, we aimed to investigate the association between Asian ethnicity and bleeding events in patients who presented with STEMI. We analyzed the Nationwide Inpatient Sample database from 2002 to 2013 and identified patients hospitalized with a primary diagnosis of STEMI. We compared clinical outcomes between patients of Asian and white ethnicity. Primary outcome was inhospital major bleeding defined as a composite of intracranial hemorrhage and blood transfusions for bleeding events. After exclusions, an estimated 1 695 680 white and 46 563 Asian patients with STEMI were included in the analysis. Asian patients had a higher incidence of inhospital major bleeding (3.6% vs 2.2%, P <.001) without a significant difference in inhospital mortality (9.3% vs 8.7%, P =.06). Asian ethnicity was an independent predictor for major bleeding (estimated odds ratio: 1.32; 95% confidence interval: 1.16-1.51; P <.001). This increased risk of bleeding would warrant further investigation of optimal treatment strategies tailored for patients with STEMI of Asian ethnicity.
AB - Bleeding is a major complication in patients presenting with ST-segment elevation myocardial infarction (STEMI). Several studies suggested that Asians are more susceptible to bleeding when treated with antiplatelets, anticoagulants, and thrombolytic agents. In our study, we aimed to investigate the association between Asian ethnicity and bleeding events in patients who presented with STEMI. We analyzed the Nationwide Inpatient Sample database from 2002 to 2013 and identified patients hospitalized with a primary diagnosis of STEMI. We compared clinical outcomes between patients of Asian and white ethnicity. Primary outcome was inhospital major bleeding defined as a composite of intracranial hemorrhage and blood transfusions for bleeding events. After exclusions, an estimated 1 695 680 white and 46 563 Asian patients with STEMI were included in the analysis. Asian patients had a higher incidence of inhospital major bleeding (3.6% vs 2.2%, P <.001) without a significant difference in inhospital mortality (9.3% vs 8.7%, P =.06). Asian ethnicity was an independent predictor for major bleeding (estimated odds ratio: 1.32; 95% confidence interval: 1.16-1.51; P <.001). This increased risk of bleeding would warrant further investigation of optimal treatment strategies tailored for patients with STEMI of Asian ethnicity.
KW - Asian
KW - acute ST-segment elevation myocardial infarction
KW - bleeding
KW - complications
KW - primary percutaneous coronary intervention
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U2 - 10.1177/0003319717730168
DO - 10.1177/0003319717730168
M3 - Article
C2 - 28905638
AN - SCOPUS:85043326092
SN - 0003-3197
VL - 69
SP - 548
EP - 554
JO - Angiology
JF - Angiology
IS - 6
ER -