JOURNAL ARTICLE

Bleeding complications in primary percutaneous coronary intervention of ST-elevation myocardial infarction in a radial center

Olivier Barthélémy, Johanne Silvain, David Brieger, Anne Mercadier, Remi Lancar, Anne Bellemain-Appaix, Farzin Beygui, Jean Philippe Collet, Dominique Costagliola, Gilles Montalescot
Catheterization and Cardiovascular Interventions 2012 January 1, 79 (1): 104-12
22162411

OBJECTIVES: We evaluated the incidence, types, and prognostic impact of bleeding complications in a non-selected patient population with ongoing STEMI treated with aggressive antithrombotic treatment and routine radial primary PCI.

BACKGROUND: Bleeding complications remain frequent and deleterious in primary PCI through femoral approach.

METHODS: STEMI patients (n = 671) were evaluated for bleeding complications using a web-based registry (e-PARIS). In-hospital bleeding was adjudicated using the TIMI definition.

RESULTS: In this non-selected, high risk population, 6.1% had cardiogenic shock on admission, 3.9% out-of-hospital cardiac arrest. Radial access (88%) was the default strategy as was abciximab (78%). Clopidogrel loading dose ranged from 300 to 900 mg. Pre-hospital fibrinolysis was rare (7.1%). Hemodynamic support devices (IABP, ECMO, Tandem Heart) were needed in 7.0%. In-hospital TIMI Major and TIMI Major/minor bleedings occurred in 2.5 and 5.7% of the population, respectively. In-hospital and 1-year mortality rates were 5.5 and 8.2%, respectively. Patients with in-hospital TIMI Major/minor bleeding had a higher 1-year mortality rate (31.6% vs. 3.8%, P < 0.001). The most frequent bleeding site was gastro-intestinal. Radial access was a strong predictor of survival (OR 0.33; 95%CI 0.17-0.56; P = 0.002).

CONCLUSIONS: In the setting of radial primary PCI, the rates and types of bleeding complications are somewhat different from those observed with femoral primary PCI. The gastro-intestinal tract has become the most frequent site of bleeding after radial primary PCI. The use of radial access appears independently associated with survival.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
22162411
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"