Coronary artery diseaseIn-Hospital Major Bleeding During ST-Elevation and Non–ST-Elevation Myocardial Infarction Care: Derivation and Validation of a Model from the ACTION Registry®-GWTG™
Section snippets
Methods
The ACTION Registry–GWTG is an ongoing National Cardiovascular Data Registry program for patients with ST-segment elevation myocardial infarction (STEMI) and those with non-STEMI (NSTEMI) admitted to participating hospitals across the United States.1 The registry is an initiative of the American College of Cardiology Foundation and the American Heart Association, with partnering support from the Society of Chest Pain Centers, the Society of Hospital Medicine, and the American College of
Results
A total of 103,890 patients with AMI were admitted to 316 participating hospitals. After exclusions, the final population consisted of 90,273 patients enrolled across 251 United States centers (Figure 1). Derivation (80% [n = 72,313]) and validation (20% [n = 17,960]) cohorts were then randomly created. In-hospital major bleeding occurred in 10.8% in the derivation and validation cohorts. Major bleeding occurred in 10.2% of patients with NSTEMI and 11.8% of those with STEMI in the derivation
Discussion
Treatment for AMI should be selected with an understanding of an individual's baseline risk for ischemic outcomes, as well as for bleeding complications.3, 4, 5, 6, 7, 8, 9 The test performance measures on excess antithrombotic dosing target safety of care, but comparisons of hospitals related to their AMI care should be risk adjusted. The ACTION Registry–GWTG major bleeding model allows such risk adjustment of bleeding on site feedback reports. In addition, the model enables baseline risk
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Cited by (189)
Prediction of clinical outcomes after percutaneous coronary intervention: Machine-learning analysis of the National Inpatient Sample
2023, International Journal of CardiologyIschemic Heart Disease
2023, Hypertension: A Companion to Braunwald's Heart DiseasePerformance of stent thrombosis and bleeding risk scores in out-of-hospital cardiac arrest due to acute coronary syndromes
2022, Archives of Cardiovascular DiseasesSimple risk-score model for in-hospital major bleeding based on multiple blood variables in patients with acute myocardial infarction
2022, International Journal of CardiologyCitation Excerpt :In contrast, blood parameters can be quickly measured and provide objective information. To date, several blood biomarkers have been reported to be potential tools for predicting the incidence of bleeding complications in patients with AMI [6–13]. Given that these biomarkers may reflect various aspects of a patient's condition, we hypothesized that a combination of biomarkers might provide more accurate and useful information for risk stratification than the information provided by an individual biomarker.
The Acute Coronary Treatment and Intervention Outcomes Network Registry–Get With the Guidelines (ACTION Registry–GWTG) is an initiative of the American College of Cardiology Foundation, Washington, District of Columbia, and the American Heart Association, Dallas, Texas, with partnering support from Society of Chest Pain Centers, Dublin, Ohio, the Society of Hospital Medicine, Philadelphia, Pennsylvania, and the American College of Emergency Physicians, Irving, Texas. The registry is sponsored by Bristol-Myers Squibb (New York, New York)/Sanofi Pharmaceuticals (St. Louis, Missouri). This project received infrastructure support from the Agency for Healthcare Research and Quality, Rockville, Maryland, under grant U18HS016964. The content is solely the responsibility of the investigators and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. The funding source had no role in the design or implementation of the study or in the decision to seek publication.