Access-Site vs Non-Access-Site Major Bleeding and In-Hospital Outcomes Among STEMI Patients Receiving Primary PCI

Thibert, Michael J.; Fordyce, Christopher B.; Cairns, John A.; Turgeon, Ricky D.; Mackay, Martha; Lee, Terry; Tocher, W.; Singer, Joel; Perry-Arnesen, Michele; Wong, Graham C.

doi:10.1016/j.cjco.2021.02.009

Cited by 2 publications

(1 citation statement)

References 33 publications

(60 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, incidence rates for major bleeding are lower with non-vitamin K antagonist OAC (NOAC) compared to vitamin K antagonist (VKA), and to clopidogrel compared with prasugrel or ticagrelor [ 15 , 16 ]. Intracranial hemorrhage is one of the most dreaded complications of antithrombotic therapy, with incidence rates between 0.4 and 1.4 per 100 person-years, being highest among patients treated with TAT including a VKA [ 17 ]. Of note, the use of NOACs is associated with a marked reduction of intracranial hemorrhage compared to VKA [ 18 ].…”

Section: Incidence Of Bleeding After Pcimentioning

confidence: 99%

Bleeding Complications in Patients Undergoing Percutaneous Coronary Intervention

Galli¹,

Laborante²,

Andreotti³

et al. 2022

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

Percutaneous coronary intervention (PCI) is considered a relatively safe procedure associated with low rates of complications, but is inevitably associated with short and mid-to-long term increased bleeding risk. Besides the short term risk associated with the arterial access to perform PCI, enhanced bleeding risk persists for several months, given the need for antithrombotic therapy to prevent procedurerelated thrombotic complications as well as ischemic recurrences. Bleeding is a powerful harbinger of adverse outcomes. This awareness has fuelled intense research on bleeding reduction strategies, including new PCI devices and techniques as well as new medications and antithrombotic regimens. We here review the mechanisms and prevalence of bleeding in PCI patients, discuss the available evidence from a practical point of view, and explore future perspectives on how to treat and prevent bleeding complications in these patients.

show abstract

Section: Incidence Of Bleeding After Pcimentioning

confidence: 99%

Bleeding Complications in Patients Undergoing Percutaneous Coronary Intervention

Galli¹,

Laborante²,

Andreotti³

et al. 2022

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

Incidence and Predictors of Adverse Events Among Initially Stable ST‐Elevation Myocardial Infarction Patients Following Primary Percutaneous Coronary Intervention

Amon

Wong

Lee

et al. 2022

JAHA

View full text Add to dashboard Cite

Background Cardiac intensive care units were originally created in the prerevascularization era for the early recognition of ventricular arrhythmias following a myocardial infarction. Many patients with stable ST‐segment–elevation myocardial infarction (STEMI) are still routinely triaged to cardiac intensive care units after a primary percutaneous coronary intervention (pPCI), independent of clinical risk or the provision of critical care therapies. The aim of this study was to determine factors associated with in‐hospital adverse events in a hemodynamically stable, postreperfusion population of patients with STEMI. Methods and Results Between April 2012 and November 2019, 2101 consecutive patients with STEMI who received pPCI in the Vancouver Coastal Health Authority were evaluated. Patients were stratified into those with and without subsequent adverse events, which were defined as cardiogenic shock, in‐hospital cardiac arrest, stroke, re‐infarction, and death. Multivariable logistic regression models were used to determine predictors of adverse events. After excluding patients presenting with cardiac arrest, cardiogenic shock, or heart failure, the final analysis cohort comprised 1770 stable patients with STEMI who had received pPCI. A total of 94 (5.3%) patients developed at least one adverse event: cardiogenic shock 55 (3.1%), in‐hospital cardiac arrest 42 (2.4%), death 28 (1.6%), stroke 21 (1.2%), and re‐infarction 5 (0.3%). Univariable predictors of adverse events were older age, female sex, prior stroke, chronic kidney disease, and atrial fibrillation. There was no significant difference in reperfusion times between those with and without adverse events. Following multivariable adjustment, moderate to severe chronic kidney disease (creatinine clearance <44 mL/min; 13% of cohort) was associated with adverse events (odds ratio 2.24 [95% CI, 1.12–4.48]) independent of reperfusion time, age, sex, smoking status, hypertension, diabetes, and prior myocardial infarction/PCI/coronary artery bypass grafting. Conclusions Only 1 in 20 initially stable patients with STEMI receiving pPCI developed an in‐hospital adverse event. Moderate to severe chronic kidney disease independently predicted the risk of future adverse events. These results indicate that the majority of patients with STEMI who receive pPCI may not require routine admission to a cardiac intensive care unit following reperfusion.

show abstract

Access-Site vs Non-Access-Site Major Bleeding and In-Hospital Outcomes Among STEMI Patients Receiving Primary PCI

Cited by 2 publications

References 33 publications

Bleeding Complications in Patients Undergoing Percutaneous Coronary Intervention

Bleeding Complications in Patients Undergoing Percutaneous Coronary Intervention

Incidence and Predictors of Adverse Events Among Initially Stable ST‐Elevation Myocardial Infarction Patients Following Primary Percutaneous Coronary Intervention

Contact Info

Product

Resources

About