SynthesisBMJ open2019
Incidence and prognostic impact of post discharge bleeding post acute coronary syndrome within an outpatient setting: a systematic review.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 25 citations in OpenAlex.
- Trial
- Article
- Article
- Decoding Bleeding Risks and Survival in Patients Undergoing Percutaneous Coronary Intervention on Antiplatelet Therapy.JACC. Asia · 2025Review
- Antiplatelet Therapy in Heart Disease.Reviews in cardiovascular medicine · 2025Review
- Post-discharge major bleeding/all-cause death in acute coronary syndrome: academic research consortium criteria versus Japan-specific criteria.BMC cardiovascular disorders · 2025Article
- Cost-effectiveness of implementing a genotype-guided de-escalation strategy in patients with acute coronary syndrome.European heart journal. Cardiovascular pharmacotherapy · 2025Observational
- Association of Prognostic Nutritional Index with Post-Discharge Bleeding After Percutaneous Coronary Intervention in ACS Patients on DAPT.Therapeutics and clinical risk management · 2025Article
- Transfusion and clinical outcomes after percutaneous coronary intervention.Scientific reports · 2024Article
- De-escalation or abbreviation of dual antiplatelet therapy in acute coronary syndromes and percutaneous coronary intervention: a Consensus Statement from an international expert panel on coronary thrombosis.Nature reviews. Cardiology · 2023Review
- Impact of Coexisting Risk Factors on Outcomes in Patients with Acute Coronary Syndrome: A Real-World Analysis Using the Taiwan Chang Gung Research Database.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Impact of recurrent ischaemic and bleeding events on quality of life in patients with acute coronary syndrome: Insights from the FORCE-ACS registry.Open heart · 2023Article
- Single antiplatelet therapy directly after percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome patients: the OPTICA study.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Cost-effectiveness of clopidogrel vs. ticagrelor in patients of 70 years or older with non-ST-elevation acute coronary syndrome.European heart journal. Cardiovascular pharmacotherapy · 2022Article
- Incidence and predictors of serious bleeding during long-term follow-up after acute coronary syndrome in a population-based cohort study.Scientific reports · 2021Article
- Predictive value of the age, creatinine and ejection fraction score in patients undergoing primary percutaneous coronary intervention with bail-out tirofiban therapy.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2021Article
- Prescription Rates for Antiplatelet Therapy (APT) in Coronary Artery Disease (CAD) - What Benchmark are We Aiming at in Continuing Medical Education (CME)?Journal of European CME · 2020Article
- Bleeding After Hospital Discharge Following Acute Coronary Syndrome: Incidence, Types, Timing, and Predictors.Journal of the American Heart Association · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe primary objective was to determine the incidence of bleeding events post acute coronary syndrome (ACS) following hospital discharge. The secondary objective was to determine the prognostic impact of bleeding on mortality, major adverse cardiovascular events (MACE), myocardial re-infarction and rehospitalisation in the postdischarge setting.
designA narrative systematic review. DATA SOURCE: Medline, Embase, Amed and Central (Cochrane) were searched up to August 2018. STUDY SELECTION: For the primary objective, randomised controlled trials (RCT) and observational studies reporting on the incidence of bleeding post hospital discharge were included. For the secondary objective, RCTs and observational studies that compared patients with bleeding versus those without bleeding post hospital discharge vis-à-vis mortality, MACE, myocardial re-infarction and rehospitalisation were included.
results53 studies (36 observational studies and 17 RCTs) with a combined cohort of 714 458 participants for the primary objectives and 187 317 for the secondary objectives were included. Follow-up ranged from 1 month to just over 4 years. The incidence of bleeding within 12 months post hospital discharge ranged from 0.20% to 37.5% in observational studies and between 0.96% and 39.4% in RCTs. The majority of bleeds occurred in the initial 3 months after hospital discharge with bruising the most commonly reported event. Major bleeding increased the risk of mortality by nearly threefold in two studies. One study showed an increased risk of MACE (HR 3.00,95% CI 2.75 to 3.27; p<0.0001) with bleeding and another study showed a non-significant association with rehospitalisation (HR 1.20,95% CI 0.95 to 1.52; p=0.13).
conclusionBleeding complications following ACS management are common and continue to occur in the long term after hospital discharge. These bleeding complications may increase the risk of mortality and MACE, but greater evidence is needed to assess their long-term effects. PROSPERO REGISTRATION NUMBER: CRD42017062378.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.