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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Procedure-related bleeding in elective percutaneous coronary interventions

Gjin Ndrepepa1, Tilman Stephan, Katrin Anette Fiedler

  • 1Deutsches Herzzentrum, Technische Universität, Munich, Germany.

European Journal of Clinical Investigation
|February 4, 2015
PubMed

Insights

Procedure-related bleeding in patients with stable coronary artery disease undergoing percutaneous coronary intervention increases 1-year mortality risk. This highlights the importance of managing bleeding events post-PCI for better patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • The prognostic impact of bleeding during percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) is not fully understood.
  • Investigating the link between peri-procedural bleeding and long-term outcomes is crucial for patient management.

Purpose of the Study:

  • To determine the association between bleeding occurring within 30 days of elective PCI and 1-year mortality in patients with stable CAD.
  • To assess the impact of procedure-related bleeding on the effectiveness of PCI in reducing mortality.

Main Methods:

  • A cohort of 9035 patients with stable CAD undergoing elective PCI was analyzed.
  • Bleeding events were classified using Bleeding Academic Research Consortium (BARC) criteria within 30 days post-PCI.
  • The primary endpoint was 1-year all-cause mortality.

Main Results:

  • Bleeding occurred in 9.3% of patients; actionable bleeding (BARC class ≥ 2) in 4.9%.
  • One-year mortality was 4.9% in patients with bleeding versus 2.1% without bleeding (OR = 2.41, P < 0.001).
  • Bleeding remained a significant independent predictor of 1-year mortality (aHR = 1.87, P = 0.002) and improved predictive models.

Conclusions:

  • Peri-PCI bleeding in stable CAD patients is significantly associated with increased 1-year mortality.
  • Procedure-related bleeding may compromise the mortality benefits of elective PCI in stable CAD.
  • Minimizing bleeding complications is essential for optimizing PCI outcomes in this patient population.
Abstract

Keywords:
Bleedingmortalitymyocardial infarctionpercutaneous coronary interventionstable coronary artery disease

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