Blood pressure and risks of vascular complications after percutaneous coronary intervention.
Evidence-based protocols are needed for care of the nearly 1,000,000 patients in the United States who undergo percutaneous coronary interventional procedures. This article describes a case-matched control study of 300 patients undergoing percutaneous coronary intervention in which specific demographic, physician-sensitive, and nurse-sensitive factors were tested to determine their relative contribution to the incidence of vascular complications. Findings included that patients with a mean systolic blood pressure of 160 mm Hg or higher were 8 times more likely to have vascular complications (P < .001). Patients receiving heparin (with and without glycoprotein IIb/IIIa inhibitors) versus bivalirudin were 3 times more likely to have vascular complications (P = .008). Patients with hemostasis by AngioSeal and those with a history of hypertension were 77% (P =.031) and 61% (P = .005), respectively, less likely to have complications.
Dumont
Cheryl J P
CJ
Winchester Medical Center, VA 22602, USA. cdumont@valleyhealthlink.com
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000451:nursing; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D019317:Evidence-Based Medicine; D005260:Female; D006488:Hemostasis, Surgical; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing; D024802:Nurse's Role; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use; D019990:Perioperative Care / Q000379:methods / Q000451:nursing / Q000592:standards; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D014768:Virginia / Q000453:epidemiology
D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin