0
Abstract: Poster Presentations |

RISK FACTORS FOR MAJOR BLEEDING AFTER PERCUTANEOUS CORONARY INTERVENTION IN 634 CONSECUTIVE PATIENTS WITH ACUTE CORONARY SYNDROMES FREE TO VIEW

Joo H. Yoon, MD*; Wilbert S. Aronow, MD; Bredy Pierre-Louis, MD; Chul Ahn, PhD; Kumar Kalapatapu, MD; Anthony L. Pucillo, MD; Craig E. Monsen, MD
Author and Funding Information

New York Medical College, Valhalla, NY


Chest


Chest. 2009;136(4_MeetingAbstracts):107S. doi:10.1378/chest.136.4_MeetingAbstracts.107S-b
Text Size: A A A
Published online

Abstract

PURPOSE:  To investigate in consecutive patients who had percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) risk factors for major bleeding.

METHODS:  We investigated in 634 consecutive patients who had PCI) for ACS risk factors for major bleeding. Major bleeding was defined as intracerebral or intraocular bleeding, clinical bleeding requiring blood transfusion, clinical bleeding with a reduction in hematocrit > 10 points, retroperitoneal or gastrointestinal bleeding, access site bleeding requiring intervention, and a ≥ 4 cm diameter hematoma at the site of vascular access.

RESULTS:  Of 634 patients, 34 (5%) had major bleeding, 253 (40%) minor bleeding, and 347 (55%) had no bleeding. Significant independent risk factors for major bleeding were increased troponin I level (p = 0.004, odds ratio = 4.7), prior coronary artery disease (p = 0.029, odds ratio = 3.7), platelet glycoprotein IIb/IIIa inhibitors (p = 0.002, odds ratio = 9.8), glomerular filtration rate (GFR) < 30 versus ≥ 60 ml/min/1.73m2 (p < 0.0001, odds ratio = 39.7), GFR 30–59 versus ≥ 60 ml/min/1.73m2 (p = 0.0001, odds ratio = 9.4), and clopidogrel loading dose > 300 mg (p = 0.0001, odds ratio = 8.9). In-hospital death occurred in 5 of 34 patients (15%) with major bleeding and in none of 600 patients (0%) with minor or no bleeding after PCI (p < 0.0001). Hospital duration was 11.0 days in patients with major bleeding, 3.4 days in patients with minor bleeding, and 1.8 days in patients with no bleeding (p < 0.0001).

CONCLUSION:  In-hospital mortality and hospital duration were significantly higher in patients with major bleeding than in patients with minor or no bleeding after PCI for ACS. Significant risk factors for major bleeding were increased troponin I level, prior coronary disease, platelet glycoprotein IIb/IIIa inhibitors, abnormal GFR, and clopidogrel loading dose > 300 mg.

CLINICAL IMPLICATIONS:  Major bleeding is associated with increased in-hospital mortality and hospital duration after PCI for ACS. Risk factors for major bleeding are increased troponin I level, prior coronary disease, platelet glycoprotein IIb/IIIa inhibitors, abnormal GFR, and clopidogrel loading dose > 300 mg.

DISCLOSURE:  Joo Yoon, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543