ArticleCirculation reports2026
Limited Impact of High Bleeding Risk Calculation and Peri-Procedural Discussion on Dual-Antiplatelet Therapy Duration and Clinical Outcomes After Percutaneous Coronary Intervention.
Article in Circulation reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Japanese version of the high bleeding risk (J-HBR) criteria identifies patients with HBR undergoing percutaneous coronary intervention (PCI). We evaluated whether routine J-HBR calculation and peri-procedural discussion on dual-antiplatelet therapy (DAPT) duration were associated with changes in DAPT practice and clinical outcomes. Methods and Results: We retrospectively evaluated 793 patients who underwent PCI between August 2019 and August 2021. Routine J-HBR calculation and peri-procedural discussion on DAPT duration were introduced in August 2020, and patients were categorized into post- and pre-J-HBR groups. The median DAPT duration was 174 and 188 days (P=0.47), and guideline-directed DAPT duration was achieved in 62.6% and 56.9%, respectively (P=0.13) in the post- and pre-J-HBR groups. Clinical outcomes did not differ significantly between groups, including net adverse clinical events (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.77-1.52; P=0.65), major cardiovascular or cerebrovascular events (HR, 0.76; 95% CI, 0.44-1.32; P=0.34), and major bleeding (HR, 1.30; 95% CI, 0.90-1.89; P=0.17). Multivariable Cox proportional hazards analysis showed that routine J-HBR calculation and peri-procedural discussion were not associated with a significant reduction in major bleeding (HR, 0.97; 95% CI, 0.65-1.46; P=0.88). Conclusions: Routine J-HBR calculation and peri-procedural discussion on DAPT duration were not associated with significant changes in overall DAPT duration or clinical outcomes.
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