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The association between the extent of coronary artery disease and major bleeding events after percutaneous coronary intervention: from the ACUITY trial.
- Source :
-
The Journal of invasive cardiology [J Invasive Cardiol] 2015 Apr; Vol. 27 (4), pp. 203-11. - Publication Year :
- 2015
-
Abstract
- Objective: We sought to evaluate the relation between the extent of coronary artery disease (CAD) and bleeding risk in patients undergoing percutaneous coronary intervention (PCI) for non-ST segment elevation acute coronary syndrome (NSTEACS).<br />Background: Patients with severe CAD undergoing PCI for NSTEACS are at high risk for recurrent adverse events. Hemorrhagic events after PCI are associated with high rates of morbidity and mortality. Despite sharing many common risk factors, the relationship between the extent of CAD and bleeding after PCI remains understudied.<br />Methods: The SYNTAX score (SS) was used to quantify the extent and severity of CAD. We stratified 2627 patients from the ACUITY PCI cohort into SS groups based on score tertiles from the ACUITY trial (<7, 7-12, and >12). Thirty-day major bleeding rates were determined for each group.<br />Results: When stratified by ACUITY tertiles, 30-day major bleeding rates were significantly greater in the highest SS tertile (>12) than in the intermediate and lowest tertiles (P<.01). By multivariable analysis, the SS (by augmentation of 1 point) remained independently associated with 30-day major bleeding (hazard ratio = 1.03; 95% confidence interval, 1.01-1.04; P<.01).<br />Conclusion: The results of this large-scale study suggest that in addition to its previously described association with adverse ischemic events, the extent of CAD, as assessed by the SS, was independently associated with major bleeding after PCI for NSTEACS.
- Subjects :
- Aged
Coronary Artery Bypass
Coronary Artery Disease diagnostic imaging
Female
Humans
Male
Middle Aged
Multicenter Studies as Topic
Multivariate Analysis
Postoperative Hemorrhage epidemiology
Postoperative Hemorrhage mortality
Proportional Hazards Models
Prospective Studies
Randomized Controlled Trials as Topic
Risk Factors
Acute Coronary Syndrome surgery
Coronary Angiography
Coronary Artery Disease complications
Percutaneous Coronary Intervention adverse effects
Postoperative Hemorrhage etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1557-2501
- Volume :
- 27
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of invasive cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 25840404