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Factors related to a clinically silent peri-procedural drop in hemoglobin with coronary and peripheral vascular interventions.
MedLine Citation:
PMID:  22003001     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Clinically evident and subclinical peri-procedural bleeding following interventional therapies are associated with adverse cardiovascular outcomes. The risk factors for clinically evident bleeding have been well described. Despite the well-documented association of adverse outcomes for patients with a subclinical peri-procedural hemoglobin drop, the clinical predictors have not yet been defined. We identified 1176 consecutive patients with a subclinical drop in hemoglobin (fall of ≥ 1 g/dl in patients without clinical bleeding) following percutaneous coronary interventions (PCI) and peripheral vascular interventions (PVI). Multivariate logistic regression analysis was performed. A subclinical peri-procedural hemoglobin drop ≥ 1 g/dl was identified in 41% (400/972) of PCI and in 49% (213/435) of PVI. More than one access site predicted a higher risk of a subclinical drop in hemoglobin in both groups. A body mass index ≥ 30 predicted a lower risk of a subclinical drop in hemoglobin in both groups. For PCI, creatinine clearance < 60 ml/min was associated with a higher risk of a subclinical drop in hemoglobin. In conclusion, clinically silent peri-procedural hemoglobin fall ≥ 1 g/dl is common in patients undergoing both coronary and peripheral percutaneous intervention. Predictors identified in our study will need prospective validation.
Authors:
Zehra Jaffery; Christopher J White; Tyrone J Collins; Mark A Grise; J Stephen Jenkins; Paul W McMullan; Rajan A Patel; John P Reilly; Stanley N Thornton; Stephen R Ramee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  16     ISSN:  1477-0377     ISO Abbreviation:  Vasc Med     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  354-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Ochsner Heart and Vascular Institute, John Ochsner Clinic Foundation, New Orleans, LA, USA.
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