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Related Concept Videos

Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Predicting long-term bleeding after percutaneous coronary intervention.

Praneet K Sharma1,2, Adnan K Chhatriwalla1,2, David J Cohen1,2

  • 1Saint Luke's Mid America Heart Institute, Kansas City, Missouri.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|April 3, 2016
PubMed
Summary
This summary is machine-generated.

Bleeding events are common in the first year after percutaneous coronary intervention (PCI). A new model using patient characteristics and drug-eluting stent (DES) use can predict these long-term bleeding risks.

Keywords:
PCIantiplatelet therapybleedingdrug eluting stent

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Risk Prediction

Background:

  • Dual antiplatelet therapy (DAPT) after PCI balances ischemic event prevention with bleeding risk.
  • Existing models do not adequately predict long-term bleeding events post-PCI.

Purpose of the Study:

  • To develop and validate a predictive model for long-term bleeding events following percutaneous coronary intervention (PCI).

Main Methods:

  • Analysis of 1-year bleeding outcomes from 3,128 PCI procedures in the PRISM observational study.
  • Bleeding events categorized using Bleeding Academic Research Consortium (BARC) definitions.
  • Logistic regression used to build a predictive model for BARC ≥1 bleeding.

Main Results:

  • 18.4% of patients experienced BARC ≥1 bleeding within one year.
  • Predictors of bleeding included female sex, Caucasian ethnicity, DES implantation, and warfarin use; diabetes was protective.
  • A 10-variable model demonstrated good discrimination (c-statistic=0.667) and calibration for BARC ≥1 bleeding, and moderate discrimination for BARC ≥2 bleeding (c-statistic=0.653).

Conclusions:

  • Bleeding is a frequent complication within the first year after PCI.
  • Pre-procedural patient factors and drug-eluting stent (DES) use are significant predictors of bleeding risk.
  • The developed model can aid in shared decision-making regarding stent choice and DAPT duration.