Document Detail


Risk factors for major bleeding and for minor bleeding after percutaneous coronary intervention in 634 consecutive patients with acute coronary syndromes.
MedLine Citation:
PMID:  19455020     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Of 634 consecutive patients who had percutaneous coronary intervention (PCI) for acute coronary syndromes, 34 (5%) had major bleeding after PCI, 253 (40%) had minor bleeding after PCI, and 347 (55%) had no bleeding after PCI. Significant independent risk factors for major bleeding after PCI were increased troponin I level (P = 0.004; odds ratio [OR] = 4.7), prior coronary artery disease (P = 0.029; OR = 3.7), platelet glycoprotein IIb/IIIa inhibitors (P = 0.002; OR = 9.8), glomerular filtration rate (GFR) <30 versus >or=60 mL/min/1.73 m(2) (P < 0.0001; OR = 39.7), GFR 30-59 versus >or=60 mL/min/1.73 m(2) (P = 0.0001; OR = 9.4), and clopidogrel loading dose >300 mg (P = 0.0001; OR = 8.9). Significant independent risk factors for minor bleeding after PCI were increased troponin I level (P = 0.0004; OR = 2.1), platelet glycoprotein IIb/IIIa inhibitors (P = 0.039; OR = 2.4), GFR 30-59 versus >or=60 mL/min/1.73 m(2) (P < 0.0001; OR = 2.5), thrombolytics (P = 0.01; OR = 2.7), clopidogrel loading dose >300 mg (P < 0.0001; OR = 4.2), and systolic blood pressure during PCI (P < 0.0001; OR = 1.03 per mm Hg). In-hospital deaths included 5 of 34 patients (15%) with major bleeding, none of 253 patients (0%) with minor bleeding, and none of 347 patients (0%) with no bleeding (P < 0.0001). Hospital duration was 11.0 days in patients with major bleeding, 3.4 days in patients with minor bleeding, and 1.8 days in patients with no bleeding (P < 0.0001).
Authors:
Bredy Pierre-Louis; Wilbert S Aronow; Joo H Yoon; Chul Ahn; Kumar Kalapatapu; Anthony L Pucillo; Craig E Monsen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of therapeutics     Volume:  17     ISSN:  1536-3686     ISO Abbreviation:  Am J Ther     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9441347     Medline TA:  Am J Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e74-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / therapy*
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  methods
Blood Pressure
Female
Fibrinolytic Agents / administration & dosage,  adverse effects
Hemorrhage / etiology*
Hospital Mortality
Humans
Length of Stay
Male
Middle Aged
Platelet Aggregation Inhibitors / administration & dosage,  adverse effects
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors
Risk Factors
Severity of Illness Index
Troponin I / metabolism
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/Troponin I

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