Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia

Background: Major bleeding is a serious complication of percutaneous coronary intervention (PCI). We set out to investigate the incidence of major bleeding and its impact on hospitalisation and long-term mortality. Method: We examined seven years of registry data encompassing 16,860 PCI procedures....

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Main Authors: Wlodarczyk, J., Ajani, A., Kemp, D., Andrianopoulos, N., Brennan, A., Duffy, S., Clark, D., Reid, Christopher
Format: Journal Article
Published: Elsevier Ltd 2015
Online Access:http://hdl.handle.net/20.500.11937/9162
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author Wlodarczyk, J.
Ajani, A.
Kemp, D.
Andrianopoulos, N.
Brennan, A.
Duffy, S.
Clark, D.
Reid, Christopher
author_facet Wlodarczyk, J.
Ajani, A.
Kemp, D.
Andrianopoulos, N.
Brennan, A.
Duffy, S.
Clark, D.
Reid, Christopher
author_sort Wlodarczyk, J.
building Curtin Institutional Repository
collection Online Access
description Background: Major bleeding is a serious complication of percutaneous coronary intervention (PCI). We set out to investigate the incidence of major bleeding and its impact on hospitalisation and long-term mortality. Method: We examined seven years of registry data encompassing 16,860 PCI procedures. Results: Between 2005 and 2011 major bleeding increased from 1.3% to 3.4%. In patients with ST elevated myocardial infarction (STEMI), the rate increased from 2.3% to 6.4%. The increase remained significant after adjusting for patient and procedural characteristics (OR=1.09/year, p=0.001). Bleeding risk was highest in patients presenting with out-of-hospital cardiac arrest and cardiogenic shock (CS). Women, STEMI patients, those aged over 70yrs or weighing <60 kg were at higher risk. Glycoprotein IIb/IIIa-inhibitor use more than doubled the risk of bleeding (OR=2.28, p=<0.001). Mortality rates at one year were 4.18% overall and 7.9% in STEMI. Bleeding was a strong predictor of mortality after adjusting for potential confounders (HR=2.92, 95% CI: 2.08, 4.09). Bleeding significantly increased length of stay (med four days vs seven days) and rehospitalisation at 12 months (OR=1.36, 95% CI: 1.08, 1.70). Conclusions: Major bleeding rates post-PCI appear to be increasing in Australia. Bleeding increases hospitalisation and is associated with poor clinical outcomes.
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spelling curtin-20.500.11937-91622017-09-13T14:50:54Z Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia Wlodarczyk, J. Ajani, A. Kemp, D. Andrianopoulos, N. Brennan, A. Duffy, S. Clark, D. Reid, Christopher Background: Major bleeding is a serious complication of percutaneous coronary intervention (PCI). We set out to investigate the incidence of major bleeding and its impact on hospitalisation and long-term mortality. Method: We examined seven years of registry data encompassing 16,860 PCI procedures. Results: Between 2005 and 2011 major bleeding increased from 1.3% to 3.4%. In patients with ST elevated myocardial infarction (STEMI), the rate increased from 2.3% to 6.4%. The increase remained significant after adjusting for patient and procedural characteristics (OR=1.09/year, p=0.001). Bleeding risk was highest in patients presenting with out-of-hospital cardiac arrest and cardiogenic shock (CS). Women, STEMI patients, those aged over 70yrs or weighing <60 kg were at higher risk. Glycoprotein IIb/IIIa-inhibitor use more than doubled the risk of bleeding (OR=2.28, p=<0.001). Mortality rates at one year were 4.18% overall and 7.9% in STEMI. Bleeding was a strong predictor of mortality after adjusting for potential confounders (HR=2.92, 95% CI: 2.08, 4.09). Bleeding significantly increased length of stay (med four days vs seven days) and rehospitalisation at 12 months (OR=1.36, 95% CI: 1.08, 1.70). Conclusions: Major bleeding rates post-PCI appear to be increasing in Australia. Bleeding increases hospitalisation and is associated with poor clinical outcomes. 2015 Journal Article http://hdl.handle.net/20.500.11937/9162 10.1016/j.hlc.2015.06.826 Elsevier Ltd restricted
spellingShingle Wlodarczyk, J.
Ajani, A.
Kemp, D.
Andrianopoulos, N.
Brennan, A.
Duffy, S.
Clark, D.
Reid, Christopher
Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
title Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
title_full Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
title_fullStr Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
title_full_unstemmed Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
title_short Incidence, Predictors and Outcomes of Major Bleeding in Patients Following Percutaneous Coronary Interventions in Australia
title_sort incidence, predictors and outcomes of major bleeding in patients following percutaneous coronary interventions in australia
url http://hdl.handle.net/20.500.11937/9162