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Bleeding complications in primary percutaneous coronary intervention of ST-elevation myocardial infarction in a radial center
- Source :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 79(1)
- Publication Year :
- 2011
-
Abstract
- Objectives: We evaluated the incidence, types, and prognostic impact of bleeding complications in a non-selected patient population with ongoing STEMI treated with aggressive antithrombotic treatment and routine radial primary PCI. Background: Bleeding complications remain frequent and deleterious in primary PCI through femoral approach. Methods: STEMI patients (n = 671) were evaluated for bleeding complications using a web-based registry (e-PARIS). In-hospital bleeding was adjudicated using the TIMI definition. Results: In this non-selected, high risk population, 6.1% had cardiogenic shock on admission, 3.9% out-of-hospital cardiac arrest. Radial access (88%) was the default strategy as was abciximab (78%). Clopidogrel loading dose ranged from 300 to 900 mg. Pre-hospital fibrinolysis was rare (7.1%). Hemodynamic support devices (IABP, ECMO, Tandem Heart) were needed in 7.0%. In-hospital TIMI Major and TIMI Major/minor bleedings occurred in 2.5 and 5.7% of the population, respectively. In-hospital and 1-year mortality rates were 5.5 and 8.2%, respectively. Patients with in-hospital TIMI Major/minor bleeding had a higher 1-year mortality rate (31.6% vs. 3.8%, P < 0.001). The most frequent bleeding site was gastro-intestinal. Radial access was a strong predictor of survival (OR 0.33; 95%CI 0.17–0.56; P = 0.002). Conclusions: In the setting of radial primary PCI, the rates and types of bleeding complications are somewhat different from those observed with femoral primary PCI. The gastro-intestinal tract has become the most frequent site of bleeding after radial primary PCI. The use of radial access appears independently associated with survival. © 2011 Wiley Periodicals, Inc
- Subjects :
- Male
Time Factors
medicine.medical_treatment
Abciximab
Myocardial Infarction
Risk Factors
Odds Ratio
Hospital Mortality
Registries
Angioplasty, Balloon, Coronary
Aged, 80 and over
education.field_of_study
Mortality rate
Cardiogenic shock
Incidence
Antibodies, Monoclonal
General Medicine
Middle Aged
Clopidogrel
surgical procedures, operative
Treatment Outcome
Radial Artery
Cardiology
Female
Cardiology and Cardiovascular Medicine
Gastrointestinal Hemorrhage
TIMI
medicine.drug
medicine.medical_specialty
Paris
Ticlopidine
Population
Hemorrhage
Risk Assessment
Immunoglobulin Fab Fragments
Fibrinolytic Agents
Internal medicine
Angioplasty
medicine
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
education
Aged
Proportional Hazards Models
Retrospective Studies
Internet
business.industry
Percutaneous coronary intervention
medicine.disease
Surgery
Logistic Models
Conventional PCI
business
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 1522726X
- Volume :
- 79
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions
- Accession number :
- edsair.doi.dedup.....2e0d876db005ae096442fcabf86d4cec