[Association between perioperative bleeding post percutaneous coronary intervention and 1 year clinical outcomes in
Peiyuan He1, Yuejin Yang, Shubin Qiao
1Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Insights
Bleeding after percutaneous coronary intervention (PCI) in elderly patients significantly increases the risk of adverse cardiovascular events within one year. This finding highlights bleeding as an independent predictor of poor outcomes in this vulnerable population.
Area of Science:
- Cardiology
- Geriatric Medicine
- Interventional Cardiology
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease.
- Elderly patients represent a growing population undergoing PCI and are at higher risk for complications.
- Perioperative bleeding is a known complication of PCI, but its long-term impact on adverse cardiovascular events in the elderly requires further investigation.
Purpose of the Study:
- To assess the association between perioperative bleeding following PCI and 1-year adverse cardiovascular events in patients aged 75 years and older.
- To determine if bleeding is an independent predictor of adverse outcomes in this specific patient group.
Main Methods:
- A prospective study included 1,105 elderly patients (≥75 years) undergoing PCI.
- Patients were categorized into a peri-procedure bleeding group (n=153) and a no-bleeding group (n=952).
- Cox proportional hazards models were used to analyze the independent effect of bleeding on the composite endpoint of death and myocardial infarction.
Main Results:
- The rate of Bleeding Academic Research Consortium (BARC) ≥ 2 grade bleeding was 11.8%.
- Patients experiencing bleeding had a significantly higher rate of 1-year death and myocardial infarction (9.2% vs. 4.2%, P=0.008).
- Cox analysis revealed that BARC ≥ 2 grade bleeding was an independent predictor of 1-year death and myocardial infarction (HR=2.368, P=0.013).
Conclusions:
- Perioperative bleeding after PCI is an independent predictor of adverse cardiovascular outcomes within one year in elderly patients.
- These findings underscore the importance of minimizing bleeding complications in elderly patients undergoing PCI to improve long-term prognosis.
Objective:
To evaluate the association between perioperative bleeding post percutaneous coronary intervention (PCI) and 1 year adverse cardiovascular events in elderly patients.
Methods:
From June 2006 to August 2011, 1 105 elderly ( ≥ 75 years) patients undergoing PCI in Fuwai Hospital were prospectively included. Patients were divided into peri-procedure bleeding group (n = 153) and no bleeding group (n = 952). Cox proportional hazards model was performed to evaluate the independent effect of bleeding on the composite endpoint of death and myocardial infarction.
Results:
BARC 2 grade bleeding occurred in 9.5% (105/1 105) patients. The rate of BARC ≥ 2 grade bleeding was 11.8% (130/1 105) , and the access site-related bleeding accounted for 62.7% (96/153) of all bleeding. The composite endpoint of 1 year death and myocardial infarction was higher in bleeding group (9.2% (14/153) vs. 4.2% (40/952), P = 0.008) . The 1 year cardiac death was higher in bleeding group (3.9% (6/153) vs. 0.8% (8/952), P = 0.007), but the rate of non-cardiac death was similar between bleeding group and no bleeding group (P = 0.360). Cox proportional hazards model analysis showed that HR of 1 year death and myocardial infarction in BARC ≥ 2 grade bleeding patients was 2.368 (95%CI:1.201-4.669, P = 0.013) compared with no bleeding patients.
Conclusion:
Perioperative bleeding post PCI is an independent predictor of 1 year adverse outcomes in elderly patients( ≥ 75 years).
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