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Number of severe bleeding complications according to classification used: is unified classification of bleeding complications really necessary?

Session Poster session 1

Speaker Zuzana Motovska

Event : ESC Congress 2015

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Coronary Intervention: Complications
  • Session type : Poster Session

Authors : M Doktorova (Prague,CZ), P Vasko (Ostrava,CZ), S Jirous (Pilsen,CZ), D Vindis (Olomouc,CZ), R Rokyta (Pilsen,CZ), L Posch (Prague,CZ), Z Motovska (Prague,CZ)

Authors:
M. Doktorova1 , P. Vasko2 , S. Jirous3 , D. Vindis4 , R. Rokyta3 , L. Posch5 , Z. Motovska1 , 1Charles University of Prague, Third Faculty of Medicine and Hospital Kralovske Vinohrady - Prague - Czech Republic , 2University Hospital Ostrava - Ostrava - Czech Republic , 3University Hospital Pilsen - Pilsen - Czech Republic , 4Palacky University, Faculty of Medicine and Dentistry - Olomouc - Czech Republic , 5Charles University of Prague - Prague - Czech Republic ,

Citation:
European Heart Journal ( 2015 ) 36 ( Abstract Supplement ), 133

Aim: To compare the number of severe periprocedural bleeding complications from the total number of bleeding complications associated to diagnostic selective coronary angiography or PCI when using different classifications (TIMI, GUSTO, PLATO, BARC) and to relate these classifications to real hemodynamic status of evaluated patients.

Methods: We analysed data from 106 patients who underwent invasive procedure for ischemic heart disease (selective coronary angiography/PCI) and suffered from any type of bleeding complication.

Results: The number of bleeding according to impacts on hemodynamic status and consequent treatment shows that 54.7% of all bleedings did not need any specific therapy. Bleeding leading to death, haemorrhagic shock, hemodynamic instability, administration of blood transfusion, surgical procedure and local treatment occurred in 6.6%, 1.9%, 5.7%, 14.2%, 2.8% and 14.2%, respectively. The results comparing bleeding classifications demonstrate that the rate of severe bleeding complications may increase up to four times when different classifications are used on the same group of patients (TIMI 9.4%, GUSTO 15.1%, PLATO 39.2% and BARC 35.9%). The power of association between severe bleeding determined by these classifications and real hemodynamic compromise using Kendall's tau-c correlation is −0.4106, −0.5355, −0.5513 and −0.7552 for TIMI, GUSTO, PLATO and BARC, respectively.

Conclusion: The data show significant dependence of percentage of severe periprocedural bleeding complications on selected classification. The strongest association between severe bleeding and real hemodynamic status was found for BARC classification as this classification seems to be promising for future general use.

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