In:
European Journal of Clinical Investigation, Wiley, Vol. 45, No. 3 ( 2015-03), p. 263-273
Abstract:
Prognostic impact of procedure‐related bleeding in patients with stable coronary artery disease ( CAD ) undergoing elective percutaneous coronary intervention ( PCI ) remains incompletely investigated. The aim of this study was to investigate the association between peri‐ PCI bleeding and 1‐year outcome of patients with stable CAD . Materials and methods The study included 9035 patients with stable CAD who underwent elective PCI . Bleeding within 30 days of PCI was defined using the Bleeding Academic Research Consortium ( BARC ) criteria. The primary outcome was 1‐year mortality. Results Bleeding occurred in 844 patients (9·3%). Actionable bleeding ( BARC class ≥ 2) occurred in 442 patients (4·9%). There were 210 deaths (2·3%) at 1 year following PCI : 41 deaths among patients with bleeding and 169 deaths among patients without bleeding [Kaplan–Meier estimates of mortality, 4·9% and 2·1%; odds ratio = 2·41, 95% confidence interval ( CI ) 1·73–3·36, P 〈 0·001]. The association between bleeding and mortality remained significant after adjustment for baseline risk variables (adjusted hazard ratio = 1·87, 95% CI 1·27–2·76, P = 0·002). Bleeding increased the discriminatory power of the model regarding prediction of 1‐year mortality (absolute and relative integrated discrimination improvement, 0·006% and 16·3%, respectively, P = 0·001). Conclusions In patients with stable CAD undergoing elective PCI , the occurrence of bleeding within 30 days of the procedure was associated with increased risk of death at 1 year after PCI . These findings suggest that procedure‐related bleeding may contribute to less than optimal results of PCI in terms of mortality reduction in patients with stable CAD .
Type of Medium:
Online Resource
ISSN:
0014-2972
,
1365-2362
DOI:
10.1111/eci.2015.45.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
2004971-7
