Periprocedural Bleeding and Percutaneous Coronary Intervention Outcomes

A pooled analysis of four trials suggests that bleeding predicts outcomes, but it must be better defined before being included in composite endpoints.

Although periprocedural bleeding has predicted adverse events after percutaneous coronary intervention in some studies, including bleeding as a component of composite endpoints has been controversial. In this analysis of four randomized trials of percutaneous coronary intervention in Germany (the ISAR trials), investigators examined whether 30-day bleeding rates affected 1-year mortality.

A total of 5384 patients were included in the analysis. Major bleeding (intracranial bleeding or a decrease in hemoglobin [Hb] of >5.0 g/dL with overt signs of hemorrhage) or minor bleeding (overt hemorrhage with a decrease in Hb of 3–5 g/dL) occurred in 4.0% of patients. Mortality at 1 year was 14.1% in patients with bleeding within 30 days after PCI, comp…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI