Incidence, predictors, and prognostic implications of bleeding and blood transfusion following percutaneous coronary interventions
Section snippets
Study population
A retrospective analysis of our cardiac catheterization database identified 11,405 patients who underwent coronary intervention between 1991 and 2000 (431 patients who underwent coronary artery bypass grafting and PCI during the same admission were excluded). The final study population consisted of 10,974 patients who underwent 12,029 PCIs.
Study definitions and follow-up data
All data were confirmed by independent hospital chart review. Bleeding definitions were based on Thrombolysis In Myocardial Infarction (TIMI) criteria13 and
Baseline demographics
Major bleeding was observed in 588 patients (5.4%), minor bleeding in 1,394 patients (12.7%), and no bleeding in 8,992 patients (81.9%). Patient demographics are listed in Table 1. In those patients with acute myocardial infarction, thrombolytics were not significantly associated with bleeding. The proportion of women experiencing major bleeding (228 of 3,307; 6.9%) was 1.5 times higher than the proportion of men who developed bleeding (360 of 7,635; 4.7%). There was a downward trend in the
Discussion
The main findings of the present study of the 10,974 unselected consecutive patients who underwent PCI are: (1) periprocedural bleeding is associated with adverse in-hospital and 1-year outcomes; (2) IABP use, procedural hypotension, age >80 years and chronic renal insufficiency are strongly associated with bleeding; and (3) the need for a blood transfusion, independent of the bleeding episode, is associated with increased in-hospital and 1-year mortality. Previous reports of bleeding during
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