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Retroperitoneal Hemorrhage After Percutaneous Coronary Intervention
- Source :
- Circulation: Cardiovascular Interventions. 11
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background— Retroperitoneal hemorrhage (RH) is a rare bleeding complication of percutaneous coronary intervention, which can result as a consequence of femoral access or can occur spontaneously. This study aims to evaluate temporal changes in RH, its predictors, and clinical outcomes in a national cohort of patients undergoing percutaneous coronary intervention in the United Kingdom. Methods and Results— We analyzed RH events in patients who underwent percutaneous coronary intervention between 2007 and 2014. Multiple logistic regression models were used to identify factors associated with RH and to quantify the association between RH and 30-day mortality and major adverse cardiovascular events. A total of 511 106 participants were included, and 291 in hospital RH events were recorded (0.06%). Overall, rates of RH declined from 0.09% to 0.03% between 2007 and 2014. The strongest independent predictors of RH events were femoral access (odds ratio [OR], 19.66; 95% confidence interval [CI], 11.22–34.43), glycoprotein IIb/IIIa inhibitor (OR, 2.63; 95% CI, 1.99–3.47), and warfarin use (OR, 2.53; 95% CI, 1.07–5.99). RH was associated with a significant increase in 30-day mortality (OR, 3.59; 95% CI, 2.19–5.90) and in-hospital major adverse cardiovascular events (OR, 5.76; 95% CI, 3.71–8.95). A legacy effect was not observed; patients with RH who survived 30 days did not have higher 1-year mortality compared with those without this complication (hazard ratio, 0.97; 95% CI, 0.49–1.91). Conclusions— Our results suggest that RH is a rare event that is declining in the United Kingdom, related to transition to transradial access site utilization, but remains a clinically important event associated with increased 30-day mortality but no long-term legacy effect.
- Subjects :
- medicine.medical_specialty
Time Factors
medicine.medical_treatment
Hemorrhage
Punctures
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Risk Factors
Internal medicine
Catheterization, Peripheral
Humans
Medicine
Retroperitoneal Space
030212 general & internal medicine
Retroperitoneal hemorrhage
business.industry
Incidence
Incidence (epidemiology)
Hazard ratio
Warfarin
Anticoagulants
Percutaneous coronary intervention
Odds ratio
RC666
medicine.disease
R1
United Kingdom
Confidence interval
Treatment Outcome
Radial Artery
Cardiology and Cardiovascular Medicine
business
Complication
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 19417632 and 19417640
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Circulation: Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....3ccf780e257961285e7ac9885a34a96a