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The effect of bleeding on outcomes after PCI: one year follow-up results from a single cardiovascular center

Session Poster Session III - Friday 08:30 - 12:30

Speaker

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : PY He (Beijing,CN), YJ Yang (Beijing,CN), SB Qiao (Beijing,CN), B Xu (Beijing,CN), YJ Wu (Beijing,CN), JQ Yuan (Beijing,CN), Y Wu (Beijing,CN), YD Tang (Beijing,CN), JG Yang (Beijing,CN), RL Gao (Beijing,CN)

Authors:
PY He1 , YJ Yang1 , SB Qiao1 , B Xu1 , YJ Wu1 , JQ Yuan1 , Y Wu1 , YD Tang1 , JG Yang1 , RL Gao1 , 1Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Cardiology - Beijing - China, People's Republic of ,

Citation:

Purpose: Bleeding is common after percutaneous coronary intervention due to the aggressive use of antithrombotic drugs. Previous studies indicated that bleeding was associated with great risk of adverse cardiovascular events for patients undergoing PCI. However, the extent of the association was not clear. When a unified bleeding definition was issued, we decided to test it among a Chinese population.

Methods: 23,389 patients who have undergone PCI with implantation of stent were recruited. Using the Bleeding Academic Research Consortium (BARC) definition, bleeding was classified as different severities. It was also stratified as access related or non-access related. Patients were prospectively followed for one year. The primary endpoint was defined as all-cause death and myocardial infarction (MI) at one-year follow-up.

Results: Among 23,389 patients, 1913 patients (8.2%) had bleeding. Patients with bleeding had higher rate of death at one-year follow-up (1.3% vs. 0.7%, P = 0.017), mainly driven by cardiac death (0.9% vs. 0.5%, P = 0.012), while non cardiac death was similar between patients with and without bleeding (0.5% vs. 0.3%, P > 0.05). This difference for mortality was not significant after adjustment, but kept significant for MI [1.50 (1.07, 2.11), P = 0.018]. Moderate bleeding which included BARC 1 and BARC 2 grade bleeding was not associated with higher rate of death or MI at one-year follow-up. Severe bleeding which included BARC = 3 grade bleeding was associated with higher rate of MI [3.89 (2.13, 7.13), P < 0.001], but not of death [1.97 (0.87, 4.49), P =0.105] after one-year discharge. Access related severe bleeding was associated with higher rate of MI [4.10 (1.93, 8.69), P<0.001]. And non-access related severe bleeding was associated with both higher rates of death [3.09 (1.16, 8.20), P < 0.001] and MI [3.60 (1.38, 9.38), P < 0.001] at one-year follow-up.

Conclusions: Bleeding put great risk of adverse cardiovascular events to patients undergoing PCI. Severe bleeding, both access or non-access related, should be carefully prevented.

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