Document Detail


Incidence, predictors and prognostic importance of bleeding after primary PCI for ST-elevation myocardial infarction.
MedLine Citation:
PMID:  20542805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To investigate incidence, predictors and prognosis of bleeding in ST elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: A large scale, prospective, observational study was performed between 1991 and 2004 in a single teaching hospital in The Netherlands including all consecutive STEMI patients who underwent primary PCI. The independent association between both major and minor bleeding and one year mortality was evaluated using Cox proportional hazard models. A total of 5,030 patients were included, of whom 109 patients (2%) had cardiac surgery within 48 hours. Data on bleeding <48 hours were available in 4,717 patients (96%). Of these, 80 (1.6%) had major bleeding, whereas minor bleeding was observed in 266 patients (5.6%). Independent predictors of minor bleeding were advanced age, multivessel disease, Killip class > or = 2 on admission, anterior MI location and TIMI 0 flow before PCI. Killip class > or = 2 on admission was an independent predictor of major bleeding. Major bleeding (HR 3.5 [95% CI 2.3-5.4]) was associated with an increased risk of death at one year. CONCLUSIONS: After primary PCI, the incidence of major bleeding is less than 2%. Although relatively infrequent, major bleeding complications are strongly and independently related to short- and midterm mortality.
Authors:
Renicus S Hermanides; Jan-Paul Ottervanger; Jan-Henk E Dambrink; Menko-Jan de Boer; Jan C A Hoorntje; A T Marcel Gosselink; Harry Suryapranata; Arnoud W J van 't Hof
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  6     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  106-11     Citation Subset:  IM    
Affiliation:
Isala klinieken, Location Weezenlanden, Department of Cardiology, Zwolle, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  mortality
Anticoagulants / adverse effects
Chi-Square Distribution
Female
Hemorrhage / etiology*,  mortality
Hospitals, Teaching
Humans
Incidence
Kaplan-Meiers Estimate
Logistic Models
Male
Middle Aged
Myocardial Infarction / therapy*
Netherlands
Platelet Aggregation Inhibitors / adverse effects
Proportional Hazards Models
Prospective Studies
Registries
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors

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