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Bleeding Severity After Percutaneous Coronary Intervention.

Björn Redfors1, Philippe Généreux2, Bernhard Witzenbichler1

  • 1From the Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (B.R., P.G., A.J.K., T.M., G.W., A.M., R.M., G.W.S.); Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); Gagnon Cardiovascular Institute, Morristown Medical Center, NJ (P.G.); Hôpital du Sacré-Coeur de Montréal, Québec, Canada (P.G.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Center for Interventional Vascular Therapy, NewYork-Presbyterian Hospital/Columbia University Medical Center (A.J.K., A.M., G.W.S.); Montefiore Medical Center, Bronx, NY (G.W.); LeBauer-Brodie Center for Cardiovascular Research and Education at Cone Health, Greensboro, NC (T.D.S.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); and The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.).

Circulation. Cardiovascular Interventions
|June 6, 2018
PubMed
Summary
This summary is machine-generated.

Severe bleeding after percutaneous coronary intervention, indicated by a hemoglobin drop of 4.0 g/dL or more, significantly increases mortality risk. This finding highlights the importance of monitoring bleeding severity in PCI patients.

Keywords:
hemoglobinhemorrhageregistriesstents

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Area of Science:

  • Cardiology
  • Hematology
  • Interventional Cardiology

Background:

  • In-hospital bleeding following percutaneous coronary intervention (PCI) is a known predictor of increased mortality.
  • Assessing bleeding severity, defined by hemoglobin (Hgb) reduction from baseline (ΔHgb), is crucial for risk stratification.

Purpose of the Study:

  • To investigate the association between the magnitude of hemoglobin drop (ΔHgb) after PCI and the risk of death and major adverse cardiac events (MACE).

Main Methods:

  • Analysis of 7608 patients from the ADAPT-DES registry who underwent successful PCI.
  • Categorization of patients based on post-PCI ΔHgb levels.
  • Evaluation of 2-year mortality and MACE risk across different ΔHgb categories.

Main Results:

  • A significant increase in 2-year mortality risk was observed with greater ΔHgb, reaching 9.8% for ΔHgb ≥4.0 g/dL (P=0.03).
  • Patients with ΔHgb ≥4.0 g/dL had a 3.39-fold increased risk of MACE (P<0.001), and those with ΔHgb ≥3.0 to <4.0 g/dL had a 2.17-fold increased risk (P=0.002).

Conclusions:

  • Significant bleeding events, defined as ΔHgb ≥4.0 g/dL, are strongly associated with a considerably increased risk of mortality in patients post-PCI.
  • These findings underscore the prognostic significance of severe bleeding in the context of successful PCI.