Incidence, predictors and prognostic implications of bleeding complicating primary percutaneous coronary intervention

Matić, Dragan; Ašanin, Milika; Stankovic, S.; Mrdović, Igor; Marinković, Jelena; Kocev, Nikola; Antonijević, Nebojša; Marjanović, M.; Nesic, Zorica; Prostran, Milica; Stanković, Goran

doi:10.2298/vsp140223064m

Cited by 16 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Anticoagulant treatment used in general high-risk interventions is similar to the method used in conventional interventions. The activated coagulation time in such patients must be maintained over 300 sec using unfractionated heparin (11). Aspirin should be administered routinely, while thienopyridine-type drugs (clopidogrel, ticagrelor) through stent implantation are routinely used.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of safety and efficacy of elective PCI in patients with cardiac insufficiency

Jing

Zhang

Chen

2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

We analyzed the safety and the efficacy of the treatment with elective percutaneous coronary intervention (PCI) in patients with coronary heart disease complicated with cardiac insufficiency. We enrolled 217 patients diagnosed with chronic ischemic heart disease complicated with cardiac failure. According to the type of treatment they received, patients were divided into 3 groups: i) The conservative treatment group with 60 patients (they received standard medication); ii) the early PCI group with 82 cases (their condition was stabilized, surgical risk was assessed and PCI was taken as early as possible); and iii) the advanced PCI group with 75 cases (ischemic myocardium was corrected and then elective PCI was applied and for aggravated myocardial ischemia cases, PCI was applied after assessing the risk of surgery). Follow-up visits were set for approximately 3 years and clinical outcomes were compared. Our results showed that the survival time in the early PCI group was significantly prolonged and the survival rate was considerably increased during 3 years. Left ventricular ejection fraction in the early PCI group markedly increased and left ventricular end-diastolic diameter and pro-BNP level decreased significantly. The occurrence rates of perioperative complications in the early PCI group and major adverse cardiac events (MACE) during the follow-up period were significantly reduced. Quality of life scores in the early PCI group markedly improved. We concluded that in patients with coronary heart disease complicated with cardiac insufficiency, early PCI treatment was safe and effective.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of safety and efficacy of elective PCI in patients with cardiac insufficiency

Jing

Zhang

Chen

2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

show abstract

“…65,66 The incidence of bleeding in patients with ACS and primary PCI is up to 14%, varying from 0.2 to 9.1% for major bleeding. 67,68 Bleeding complications, both access and nonaccess site bleeding, are independent risk factors for periprocedural mortality (RR, 4.06; 95% CI, 3.21-5.14 vs. RR, 1.71; 95% CI, 1.37-2.13). 69 Patients with major bleeding events have a significantly higher 30 days mortalitity compared with patients without bleeding (12.8 vs. 2.5%).…”

Section: Assessment Of Effects Of Antiplatelet Therapy In High-risk Pmentioning

confidence: 99%

“…65,66 The most important predictors of bleeding are summarized in ►Table 4. 11,57,67,70,71 New antiplatelet agents (e.g., ticagrelor and prasugrel) provide more rapid and higher degree of ADP-mediated inhibition of platelet aggregation than clopidogrel, and are superior to clopidogrel for preventing ischemic complications, but they are also associated with higher risks of bleeding. 66,70 Administration of clopidogrel in patients with the noted risk factors for bleeding (►Table 4) can be better managed with the more potent antiplatelet agents, especially as a part of the DAP.…”

Section: Assessment Of Effects Of Antiplatelet Therapy In High-risk Pmentioning

confidence: 99%

Practical Aspects of Monitoring of Antiplatelet Therapy

Jovanović¹,

Antonijević

Novakovic

et al. 2016

Semin Thromb Hemost

Self Cite

View full text Add to dashboard Cite

Despite the application of new antiplatelet drugs (prasugrel and ticagrelor), dual antiplatelet therapy with clopidogrel and aspirin remains the standard for patients with acute coronary syndrome undergoing percutaneous coronary intervention, especially in countries of low socioeconomic status. Regardless of the proven benefits, numerous studies have shown that certain groups of patients who receive standard doses of clopidogrel and aspirin do not respond adequately, and many of them also exhibit adverse cardiovascular events. Studies have shown that the risk of stent thrombosis and ischemic complications is higher in patients with: acute coronary syndrome, diabetes mellitus, thrombocytosis, reduced systolic function of the left ventricle with ejection fraction less than 30%, presence of multiple stents, longer and thinner stents, and renal failure. In these patients it is particularly important to assess the response to clopidogrel and selecting adequate antiplatelet therapy; this provides an impetus for platelet function tests. The second especially significant group to target for laboratory evaluation includes patients with increased risk of bleeding, such as elderly patients, patients with low body weight, anemia, thrombocytopenia, renal failure, past or current ventricular or duodenal ulcer, coagulopathy, or liver disease. The third important application of platelet function tests entails the preparation and evaluation of the time for surgical interventions or invasive diagnostic procedures in patients on antiplatelet therapy. These tests can also be helpful for monitoring the effects of therapy of bleeding due to platelet dysfunction. For high-risk patients the careful selection of optimal antiplatelet drug(s) on the basis of estimated individual risk of thrombosis and bleeding, pharmacodynamic characteristics of each drug, and patient̀s comorbidity remains essential.

show abstract

“…Lao D et al further demonstrated that leukocytosis is an independent predictor in CAD patients after PCI [6]. A large number of recent studies confirmed that the increase in baseline WBC count is associated with the occurrence of adverse clinical outcomes after PCI in patients with CAD [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Baseline white blood cell count-to-apolipoprotein A1 ratio as a novel predictor of long-term adverse outcomes in patients who underwent percutaneous coronary intervention: a retrospective cohort study

et al. 2020

View full text Add to dashboard Cite

Background: Previous studies suggested that baseline white blood cell count and apolipoprotein A1 levels were associated with clinical outcomes in patients with coronary heart disease (CAD) who underwent percutaneous coronary intervention (PCI). However, the ratio of baseline white blood cell count-to-apolipoprotein A1 level (WAR) and CAD after PCI have not been investigated. The present study investigated the effects of baseline WAR on longterm outcomes after PCI in patients with CAD. Methods: A total of 6050 patients with CAD who underwent PCI were included in the study. Of these, 372 patients were excluded because no baseline white blood cell counts or apolipoprotein A1 (ApoA1) data was available or because of malignancies or other diseases. Finally, 5678 patients were enrolled in the present study and were divided into 3 groups according to WAR value: lower group-WAR< 5.25 (n = 1889); median group-5.25 ≤ WAR≤7.15 (n = 1892); and higher group-WAR≥7.15 (n = 1897). The primary endpoint was long-term mortality, including all-cause mortality (ACM) and cardiac mortality (CM), after PCI. The average follow-up time was 35.9 ± 22.6 months. Results: A total of 293 patients developed ACM, including 85 (4.5%) patients in the lower group, 90 (4.8%) patients in the median group, and 118 (6.2%) patients in the higher group. The risk of ACM, cardiac mortality (CM), major adverse cardiovascular and cerebrovascular events (MACCEs), and major adverse cardiovascular events (MACEs) increased 62.6% (hazard risk [

show abstract

Incidence, predictors and prognostic implications of bleeding complicating primary percutaneous coronary intervention

Cited by 16 publications

References 0 publications

Evaluation of safety and efficacy of elective PCI in patients with cardiac insufficiency

Evaluation of safety and efficacy of elective PCI in patients with cardiac insufficiency

Practical Aspects of Monitoring of Antiplatelet Therapy

Baseline white blood cell count-to-apolipoprotein A1 ratio as a novel predictor of long-term adverse outcomes in patients who underwent percutaneous coronary intervention: a retrospective cohort study

Contact Info

Product

Resources

About