Coronary disease & ACS

Fatal, ischemic and bleeding risk of patients meeting the selection criteria of the TWILIGHT trial: Insights from a large percutaneous coronary intervention (PCI) registry

Am Heart JPublished Retrospective registry cohort study

Main finding · All-cause deathResult — go to the resultHazard ratio 3.63 95% CI 1.70–7.77

Authors' conclusion

Among patients not meeting the TWILIGHT exclusion criteria from a large PCI registry, the high-risk inclusion criteria of the TWILIGHT trial were met by the majority of patients and were associated with an increased risk of mortality and MI and a moderately elevated risk of bleeding.

Study context

Population
Patients undergoing PCI at a tertiary center 2012–2019 not meeting any TWILIGHT exclusion criterion (OAC, STEMI, cardiogenic shock, dialysis, prior stroke, thrombocytopenia)11,018 (83%) high risk
Participants
13,136 patients
Exposure
High-risk vs low-risk patients
Outcome
All-cause death
Follow-up
1 year after PCI
Methodological detailssingle-centre (tertiary center)
  • Single-centre (tertiary center)

Main finding

As reported in the abstract

1 year

Hazard ratio

3.63

95% CI 1.70–7.77

By group

High-riskvs Low-risk
HR 3.63 (95% CI 1.70–7.77)

Observational data: associations, not effects.

Secondary outcomes

OutcomeHigh-riskLow-riskHR (95% CI)
MI · 1 year1.8%0.6%2.81 (1.56–5.04)

Safety

OutcomeHigh-riskLow-riskHR (95% CI)
Major bleeding · 1 year3.3%1.8%1.86 (1.32–2.62)

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Fatal, ischemic and bleeding risk of patients meeting the selection criteria of the TWILIGHT trial: Insights from a large PCI registry. Am Heart J. Published 23 April 2023. doi:10.1016/j.ahj.2023.04.007

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