title: Strategies to minimize bleeding complications of percutaneous coronary intervention.
abstract: OBJECTIVE
  Bleeding has recently been identified as a major adverse outcome in patients with acute coronary syndromes. In this review, the importance of the association of bleeding with mortality and strategies to reduce bleeding with percutaneous coronary intervention are discussed.
  
  
  RESULTS
  Nine trials have shown an association of bleeding with mortality. The influence of major bleeding is at least equivalent to the effect of a myocardial infarction. In order to reduce bleeding, individualized risk assessment should be performed and attention paid to choice of access, antithrombotic, dose of antithrombotic, avoidance of crossing over from one antithrombotic to another, smaller sheaths and early removal as well as choice of P2Y12 inhibitor.
  
  
  CONCLUSIONS
  Individualizing treatment and strategies to reduce both ischemic events and bleeding will improve patient outcomes.
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. HarveyW@adhb.govt.nz
authors.forename: Harvey D
authors.initials: HD
authors.lastname: White
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006801:Humans; D009203:Myocardial Infarction; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors