What question did this study set out to answer?

Identify baseline clinical characteristics associated with bleeding complications after percutaneous coronary intervention (PCI) and develop a practical risk prediction algorithm.

May 9, 2009Circulation Cardiovascular Interventions

Bleeding in Patients Undergoing Percutaneous Coronary Intervention

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Identify baseline clinical characteristics associated with bleeding complications after percutaneous coronary intervention (PCI) and develop a practical risk prediction algorithm.
Analyzed data from 302,152 PCI procedures performed at 440 US centers participating in the National Cardiovascular Data Registry.
Defined bleeding as requiring transfusion, prolonged hospitalization, or a hemoglobin drop >3.0 g/dL across any anatomic site.
Developed a 15-element parsimonious model in a random 80% training cohort and validated the derived clinical score in the remaining 20% cohort.
Post-PCI bleeding complications occurred in 2.4% of patients overall.
Key independent predictors included age, gender, prior heart failure, glomerular filtration rate, peripheral vascular disease, no prior PCI, class IV heart failure, STEMI, NSTEMI, and cardiogenic shock (validation c-statistic, 0.72).
The clinical risk algorithm stratified bleeding rates across three risk tiers: 0.7% for scores ≤7, 1.8% for scores 8–17, and 5.1% for scores ≥18.

Structured PICO

Population

302,152 patients undergoing percutaneous coronary intervention (PCI) at 440 US centers participating in the National Cardiovascular Data Registry.

Outcome

Bleeding complications (defined as requiring transfusion, prolonged hospital stay, and/or a drop in hemoglobin >3.0 g/dL from any location)safety

A simplified, validated clinical risk algorithm based on 15 baseline variables can effectively estimate the risk of bleeding complications in patients undergoing PCI.

Discussion

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Implication

May aid pre-PCI bleeding risk stratification; leaves open prospective validation before clinical adoption.

Cite This Study

Mehta et al. (2009) studied this question.

synapsesocial.com/papers/69fc04f93a0f4cc134c8ee03 https://doi.org/10.1161/circinterventions.108.846741

Topics

Dual antiplatelet therapy

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Bleeding in Patients Undergoing Percutaneous Coronary Intervention

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Bleeding in Patients Undergoing Percutaneous Coronary Intervention

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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Topics

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