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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Frequency of high bleeding risk in patients undergoing percutaneous coronary intervention
Muhammad Muzaffar Mahmood1, Farwa Eajaz2, Aasif Hussain3
1Department of Cardiology, Ittefaq Hospital / Sharif Medical and Dental College, Lahore, Pakistan.
Insights
Nearly half of patients undergoing percutaneous coronary intervention have bleeding risk factors, with a quarter identified as high bleeding risk. This highlights the need for careful patient assessment in interventional cardiology.
Area of Science:
- Cardiology
- Interventional Cardiology
- Patient Safety
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
- Bleeding is a significant complication following PCI, impacting patient outcomes.
- Identifying bleeding risk factors is crucial for optimizing patient management.
Purpose of the Study:
- To determine the prevalence of bleeding risk factors in patients undergoing PCI.
- To assess the proportion of patients with high bleeding risk (HBR) based on established criteria.
Main Methods:
- A retrospective observational study analyzed data from 385 patients undergoing PCI.
- Bleeding risk factors were classified using Academic Research Consortium consensus definitions.
- High bleeding risk was defined by specific major and minor criteria.
Main Results:
- 45% of patients had at least one bleeding risk factor; 24% were classified as high bleeding risk.
- HBR was attributed to major criteria in 15.6% and minor criteria in 8.8% of patients.
- Older age, female sex, and comorbidities were associated with higher bleeding risk.
Conclusions:
- A substantial proportion of PCI patients present with bleeding risk factors.
- One in four patients undergoing PCI meets criteria for high bleeding risk.
- These findings underscore the importance of pre-procedural risk stratification for bleeding.
Objective:
To assess the prevalence of risk factors for bleeding and high bleeding risk in patients undergoing percutaneous coronary intervention.
Methods:
The single-centre retrospective observational study was conducted at Ittefaq Hospital Lahore and comprised data of patients who underwent percutaneous coronary intervention from February 2018 to December 2019. Minor and major bleeding risk factors were identified on the basis of the consensus definition of the Academic Research Consortium. Patients with high bleeding risk were identified according to the consensus-based criteria of at least one major criterion or two minor criteria. Data was analysed using SPSS 20.
Results:
Of the 385 patients, 280(72.7%) were males. The overall mean age was 57.9±11.9 years. The indication of procedure was acute coronary syndrome in 367(95%) patients. Of all the patients, 171(45%) had bleeding risk, with 94(24%) patients having a high bleeding risk. Of these, 60(15.6%) patients had high risk based on the presence of at least one major criterion and 34(8.8%) patients because of the presence of two or more minor criteria. Patients with high bleeding risk were more likely to be older and female with more co-morbidities (p<0.05).
Conclusions:
Almost half of the patients undergoing percutaneous coronary intervention were found to have at least one bleeding risk factor, and one in four patients had high bleeding risk.
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