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Updated: Feb 19, 2026

Characterization of Leukocyte-platelet Rich Fibrin, A Novel Biomaterial
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Published on: September 29, 2015

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If you prick us, do we not bleed?

Ameera Ahmed1, Timothy D Henry1

  • 1Cedars-Sinai Heart Institute, Los Angeles, California.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 7, 2017
PubMed

Insights

Women experience more bleeding after percutaneous coronary intervention (PCI), leading to higher mortality. While bivalirudin reduces bleeding compared to heparin and GPI, optimal strategies depend on patient factors and cost-effectiveness.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Women exhibit increased bleeding complications post-percutaneous coronary intervention (PCI), contributing to elevated mortality rates.
  • Bivalirudin demonstrates a reduction in bleeding events for both genders compared to combined heparin and glycoprotein IIb/IIIa inhibitor (GPI) therapy.
  • Bleeding avoidance strategies, including radial artery access and GPI avoidance, may influence the benefits of anticoagulants like bivalirudin.

Discussion:

  • The NCDR bleeding risk score effectively integrates gender, predicting both bleeding complications and mortality after PCI.
  • Tailoring bleeding reduction strategies requires consideration of individual patient profiles, institutional practices, and economic factors.
  • Further research is needed to optimize anticoagulation protocols for women undergoing PCI to minimize bleeding risks.

Key Insights:

  • Female sex is an independent predictor of increased bleeding complications and mortality following PCI.
  • Bivalirudin offers a potential advantage in reducing bleeding events compared to traditional anticoagulation regimens.
  • Risk stratification tools incorporating gender are crucial for personalized treatment decisions in PCI.

Outlook:

  • Future research should focus on sex-specific approaches to anticoagulation during PCI.
  • Development of novel antithrombotic agents with improved safety profiles for women is warranted.
  • Implementation of evidence-based bleeding avoidance strategies can significantly improve outcomes in PCI patients.

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