Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes
Bleeding severity in patients undergoing percutaneous coronary intervention (PCI), defined by the Bleeding Academic Research Consortium (BARC), portends adverse prognosis. We analysed data from 37,866 Australian patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR), and...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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MDPI
2020
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/80049 |
| _version_ | 1848764149070299136 |
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| author | Murali, Shashank Vogrin, Sara Noaman, Samer Dinh, Diem T Brennan, Angela L Lefkovits, Jeffrey Reid, Christopher Cox, Nicholas Chan, William |
| author_facet | Murali, Shashank Vogrin, Sara Noaman, Samer Dinh, Diem T Brennan, Angela L Lefkovits, Jeffrey Reid, Christopher Cox, Nicholas Chan, William |
| author_sort | Murali, Shashank |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Bleeding severity in patients undergoing percutaneous coronary intervention (PCI), defined by the Bleeding Academic Research Consortium (BARC), portends adverse prognosis. We analysed data from 37,866 Australian patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR), and investigated the association between increasing BARC severity and in-hospital and 30-day major adverse cardiac and cerebrovascular events (MACCE) (a composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularisation, or stroke). Independent predictors associated with major bleeding (BARC groups 3&5), and MACCE were also assessed. There was a stepwise increase in in-hospital and 30-day MACCE with greater severity of bleeding. Independent predictors of bleeding included female sex (Odds Ratio (OR) 1.34), age (OR 1.02), fibrinolytic therapy (OR 1.77), femoral access (OR 1.51), and ticagrelor (OR 1.42), all significant at the p < 0.001 level. Following adjustment of clinically important variables, BARC 3&5 bleeds (OR 4.37) were still predictive of cumulative in-hospital and 30-day MACCE. In conclusion, major bleeding is an uncommon but potentially fatal PCI complication and was independently associated with greater MACCE rates. Efforts to mitigate the occurrence of bleeding, including radial access and judicious use of potent antiplatelet therapies, may ameliorate the risk of short-term adverse clinical outcomes. |
| first_indexed | 2025-11-14T11:14:46Z |
| format | Journal Article |
| id | curtin-20.500.11937-80049 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:14:46Z |
| publishDate | 2020 |
| publisher | MDPI |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-800492023-04-05T06:28:22Z Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes Murali, Shashank Vogrin, Sara Noaman, Samer Dinh, Diem T Brennan, Angela L Lefkovits, Jeffrey Reid, Christopher Cox, Nicholas Chan, William Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine Bleeding Academic Research Consortium (BARC) bleeding percutaneous coronary intervention (PCI) clinical outcomes major adverse cardiac and cerebrovascular events (MACCE) BLOOD-TRANSFUSION FEMORAL ACCESS ARTERY-DISEASE MORTALITY PREDICTORS METAANALYSIS ASSOCIATION GUIDELINES ANGIOPLASTY CLOPIDOGREL Bleeding severity in patients undergoing percutaneous coronary intervention (PCI), defined by the Bleeding Academic Research Consortium (BARC), portends adverse prognosis. We analysed data from 37,866 Australian patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR), and investigated the association between increasing BARC severity and in-hospital and 30-day major adverse cardiac and cerebrovascular events (MACCE) (a composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularisation, or stroke). Independent predictors associated with major bleeding (BARC groups 3&5), and MACCE were also assessed. There was a stepwise increase in in-hospital and 30-day MACCE with greater severity of bleeding. Independent predictors of bleeding included female sex (Odds Ratio (OR) 1.34), age (OR 1.02), fibrinolytic therapy (OR 1.77), femoral access (OR 1.51), and ticagrelor (OR 1.42), all significant at the p < 0.001 level. Following adjustment of clinically important variables, BARC 3&5 bleeds (OR 4.37) were still predictive of cumulative in-hospital and 30-day MACCE. In conclusion, major bleeding is an uncommon but potentially fatal PCI complication and was independently associated with greater MACCE rates. Efforts to mitigate the occurrence of bleeding, including radial access and judicious use of potent antiplatelet therapies, may ameliorate the risk of short-term adverse clinical outcomes. 2020 Journal Article http://hdl.handle.net/20.500.11937/80049 10.3390/jcm9051426 English http://purl.org/au-research/grants/nhmrc/1136372 http://creativecommons.org/licenses/by/4.0/ MDPI fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine Bleeding Academic Research Consortium (BARC) bleeding percutaneous coronary intervention (PCI) clinical outcomes major adverse cardiac and cerebrovascular events (MACCE) BLOOD-TRANSFUSION FEMORAL ACCESS ARTERY-DISEASE MORTALITY PREDICTORS METAANALYSIS ASSOCIATION GUIDELINES ANGIOPLASTY CLOPIDOGREL Murali, Shashank Vogrin, Sara Noaman, Samer Dinh, Diem T Brennan, Angela L Lefkovits, Jeffrey Reid, Christopher Cox, Nicholas Chan, William Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes |
| title | Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes |
| title_full | Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes |
| title_fullStr | Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes |
| title_full_unstemmed | Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes |
| title_short | Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes |
| title_sort | bleeding severity in percutaneous coronary intervention (pci) and its impact on short-term clinical outcomes |
| topic | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine Bleeding Academic Research Consortium (BARC) bleeding percutaneous coronary intervention (PCI) clinical outcomes major adverse cardiac and cerebrovascular events (MACCE) BLOOD-TRANSFUSION FEMORAL ACCESS ARTERY-DISEASE MORTALITY PREDICTORS METAANALYSIS ASSOCIATION GUIDELINES ANGIOPLASTY CLOPIDOGREL |
| url | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/80049 |