Acute coronary syndrome (ACS) is a collective term used to describe conditions associated with a sudden, reduced flow to the heart. Percutaneous coronary intervention (PCI) is a non-surgical procedure that is often used as a primary line of treatment for ACS. In recent years, however, ACS is being treated without PCI as well. This study aims to investigate the post-discharge bleeding and mortality in patients with ACS (PCI or no PCI)
This is a meta-analysis of 4 multicenter randomized trials: PLATO, APPRAISE-2, TRACER, and TRILOGY ACS. The study included a total of 45,011 participants with ACS who were treated with PCI or no PCI. The impact of post-discharge bleeding was recorded and contrasted with the association between post-discharge myocardial infarction (MI) and subsequent mortality.
Out of 45,011 patients, 1,133 experienced post-discharge bleeding events (2.6 per 100 patient-years), and 2,149 died during follow-up. The risk was higher during the first 30 days after discharge. The time-related association between post-discharge bleeding and mortality was similar when compared with the association between MI and subsequent mortality.
The findings suggested that post-discharge bleeding after ACS is related to an increase in subsequent all-cause mortality, with the rate being similar to that of post-discharge MI.