Association between perioperative bleeding post percutaneous coronary intervention and 1 year clinical outcomes in elderly patients
He, P.; Yang, Y.; Qiao, S.; Xu, B.; Yao, M.; Wu, Y.; Yuan, J.; Chen, J.; Wu, Y.; Liu, H.; Dai, J.; Li, W.; Tang, Y.; Yang, J.; Gao, R.
Zhonghua Xin Xue Guan Bing Za Zhi 43(1): 26-30
2015
ISSN/ISBN: 0253-3758 PMID: 25876718 Document Number: 683515
To evaluate the association between perioperative bleeding post percutaneous coronary intervention (PCI) and 1 year adverse cardiovascular events in elderly patients. From June 2006 to August 2011, 1 105 elderly ( ≥ 75 years) patients undergoing PCI in Fuwai Hospital were prospectively included. Patients were divided into peri-procedure bleeding group (n = 153) and no bleeding group (n = 952). Cox proportional hazards model was performed to evaluate the independent effect of bleeding on the composite endpoint of death and myocardial infarction. BARC 2 grade bleeding occurred in 9.5% (105/1 105) patients. The rate of BARC ≥ 2 grade bleeding was 11.8% (130/1 105) , and the access site-related bleeding accounted for 62.7% (96/153) of all bleeding. The composite endpoint of 1 year death and myocardial infarction was higher in bleeding group (9.2% (14/153) vs. 4.2% (40/952), P = 0.008) . The 1 year cardiac death was higher in bleeding group (3.9% (6/153) vs. 0.8% (8/952), P = 0.007), but the rate of non-cardiac death was similar between bleeding group and no bleeding group (P = 0.360). Cox proportional hazards model analysis showed that HR of 1 year death and myocardial infarction in BARC ≥ 2 grade bleeding patients was 2.368 (95%CI:1.201-4.669, P = 0.013) compared with no bleeding patients. Perioperative bleeding post PCI is an independent predictor of 1 year adverse outcomes in elderly patients( ≥ 75 years).