Ndrepepa G, Neumann FJ, Schulz S, Fusaro M, Cassese S, Byrne RA, Richardt G, Laugwitz KL, Kastrati A (2014)
Publication Type: Journal article
Publication year: 2014
Book Volume: 83
Pages Range: 182-189
Journal Issue: 2
DOI: 10.1002/ccd.25189
Objectives We aimed to assess the impact of bleeding after percutaneous coronary intervention (PCI) on the outcome of patients >75 years of age. Background Limited information exists on the impact of post-PCI bleeding on the outcome in elderly patients. Methods This study included 3,255 patients >75 years of age. Bleeding events were assessed using the Bleeding Academic Research Consortium (BARC) criteria. The primary outcome was 1-year mortality. Results Within 30 days after PCI, bleeding occurred in 501 patients (15.4%). Bleeding according to BARC was: class 1 (170 patients; 33.9%), class 2 (81 patients; 16.2%), class 3a (177 patients; 35.3%), class 3b (65 patients; 13.0%), class 3c (four patients; 0.8%), and class 4 (four patients; 0.8%). There were 201 deaths within the first year after PCI: 61 deaths (12.3%) among bleeders and 140 deaths (5.1%) among nonbleeders (adjusted hazard ratio = 2.03, 95% confidence interval [CI] 1.42-2.91, P < 0.001). Bleeding improved the discriminatory power of multivariable model for mortality prediction (P = 0.001). Female sex (adjusted odds ratio [OR] = 1.49 [1.17-1.88], P = 0.001) and reduced renal function (adjusted OR = 1.30 [1.04-1.63], P = 0.019 for each 30 ml/min decrease in the creatinine clearance) were independent associates of increased bleeding risk. Bivalirudin reduced the bleeding risk by 24% compared with unfractionated heparin and 33% compared with abciximab plus unfractionated heparin. Conclusions Post-PCI bleeding is an important prognostic factor in patients >75 years of age. The risk for bleeding in this age category is increased in women and patients with impaired renal function. Bleeding risk is reduced by bivalirudin. Copyright © 2013 Wiley Periodicals, Inc.
APA:
Ndrepepa, G., Neumann, F.-J., Schulz, S., Fusaro, M., Cassese, S., Byrne, R.A.,... Kastrati, A. (2014). Incidence and prognostic value of bleeding after percutaneous coronary intervention in patients older than 75 years of age. Catheterization and Cardiovascular Interventions, 83(2), 182-189. https://doi.org/10.1002/ccd.25189
MLA:
Ndrepepa, Gjin, et al. "Incidence and prognostic value of bleeding after percutaneous coronary intervention in patients older than 75 years of age." Catheterization and Cardiovascular Interventions 83.2 (2014): 182-189.
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