Prognostic value of access and non-access sites bleeding after percutaneous coronary intervention

Ndrepepa G, Neumann FJ, Richardt G, Schulz S, Toelg R, Stoyanov KM, Gick M, Ibrahim T, Fiedler KA, Berger PB, Laugwitz KL, Kastrati A (2013)

Publication Type: Journal article

Publication year: 2013

Journal

Circulation: Cardiovascular Interventions American Heart Association

Book Volume: 6

Pages Range: 354-361

Journal Issue: 4

DOI: 10.1161/CIRCINTERVENTIONS.113.000433

Abstract

Background-Little is known about the impact of bleeding site on mortality after percutaneous coronary intervention. The aim of this study was to assess the impact of access and non-access site bleeding within 30 days after percutaneous coronary intervention on mortality. Methods and Results-This study represents a pooled patient-level analysis of 14 180 patients recruited in 7 randomized trials. Access and non-access site bleeding were assessed using the Bleeding Academic Research Consortium criteria. The primary outcome was 1-year mortality. Follow-up was complete in 97.5% of the patients. There were 414 deaths within the first year after percutaneous coronary intervention: 44 deaths among patients with access site bleeding, 60 deaths among patients with non-access site bleeding, and 310 deaths among patients without bleeding (Kaplan-Meier estimates of mortality, 4.5%, 10.0%, and 2.5%, respectively; adjusted hazard ratio, 1.72 [95% confidence interval, 1.19- 2.47] for access site bleeding versus no bleeding; hazard ratio, 2.78 [2.00-3.86] for non-access site versus no bleeding). The inclusion of non-access site bleeding (the absolute and relative integrated discrimination improvement, 0.005 and 8.9%; P=0.031) but not of access site bleeding (the absolute and relative integrated discrimination improvement, 0.0015 and 2.7%; P=0.084) was associated with an improvement of the discriminatory power of multivariable model for mortality prediction. Conclusions-Both access and non-access site bleeding events occurring within 30 days of a percutaneous coronary intervention are independently associated with an increased risk of 1-year mortality. Non-access site bleeding is a stronger correlate of mortality than access site bleeding, and it improves the discriminatory power of models for mortality prediction. © 2013 American Heart Association, Inc.

Involved external institutions

Technische Universität München (TUM) DE Germany (DE) Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH DE Germany (DE) Segeberger Kliniken DE Germany (DE)

How to cite

APA:

Ndrepepa, G., Neumann, F.-J., Richardt, G., Schulz, S., Toelg, R., Stoyanov, K.M.,... Kastrati, A. (2013). Prognostic value of access and non-access sites bleeding after percutaneous coronary intervention. Circulation: Cardiovascular Interventions, 6(4), 354-361. https://doi.org/10.1161/CIRCINTERVENTIONS.113.000433

MLA:

Ndrepepa, Gjin, et al. "Prognostic value of access and non-access sites bleeding after percutaneous coronary intervention." Circulation: Cardiovascular Interventions 6.4 (2013): 354-361.

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