Which Nonfatal Events Matter Most after PCI?

Clinical Takeaway

: A registry analysis shows that heart failure carries a higher mortality risk than acute coronary syndrome or major bleeding after percutaneous coronary intervention.

Context

Investigators often use composite outcomes as a primary measure of efficacy in clinical trials in cardiovascular disease, because the most important individual outcomes, such as mortality, occur infrequently. However, composite outcomes may obscure differences in the relative importance of the individual components. In this study, researchers used a Japanese registry cooperative to evaluate the effect on mortality of three common, nonfatal adverse cardiovascular events in patient who underwent percutaneous coronary intervention (PCI): hospitalization for heart failure (HFH), acute coronary syndrome (ACS), and major bleeding. There were 10,482 patients: 27% with ST-segment−elevation myocardial infarction (STEMI), 25% with non-STEMI or…

Reviewing Author

Frederick A. Masoudi, M.D., M.S.P.H., M.A.C.C., F.A.H.A.

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)