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Risk factors for hematoma in patients undergoing cardiac device procedures: A WRAP-IT trial analysis
Khaldoun G Tarakji1, Panagiotis Korantzopoulos2, Francois Philippon3
1Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
Heart Rhythm O2
|November 7, 2022
Summary
Hematoma risk after cardiac device procedures is linked to anticoagulant and antiplatelet medications. Understanding these factors can help manage antithrombotic therapy and reduce complications.
Area of Science:
- Cardiology
- Medical Devices
- Pharmacology
Background:
- Implant site hematoma is a recognized complication following cardiac device implantation.
- These hematomas can lead to significant adverse outcomes for patients.
Purpose of the Study:
- To identify risk factors associated with hematoma development after cardiac device procedures.
- To clarify the relationship between anticoagulant (AC) and antiplatelet (AP) medication use and hematoma occurrence.
Main Methods:
- Analysis of 6800 patients from the WRAP-IT trial.
- Utilized stepwise Cox regression to identify baseline and procedural characteristics linked to hematoma within 30 days.
- Evaluated the impact of AC/AP use on hematoma risk.
Main Results:
- The overall hematoma rate was 2.2%.
- Key risk factors included anticoagulant use (HR: 2.44), lower BMI (HR: 1.06), and prior valve surgery (HR: 2.11).
- Antiplatelet use nearly doubled hematoma risk (HR: 1.85). Heparin bridging showed the highest risk (HR: 4.98).
Conclusions:
- Identified significant risk factors for hematoma in cardiac device procedures.
- Findings can guide antithrombotic management strategies to mitigate hematoma risk.
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