High monthly temperature as a possible risk factor of local vascular bleeding complications during percutaneous coronary interventions evaluated by ultrasonography - retrospective analysis.
BACKGROUND
Bleeding complications are a very important issue in the era of percutaneous coronary interventions (PCI). Effective antiplatelet therapy increases the rate of successful interventions but the risk of bleeding complications, among them local vascular complications, may be higher. Other factors may also be important in the development of local bleeding complications.


OBJECTIVE
To examine the relationship between air temperature and local haemorrhagic complications.


METHODS
The retrospective analysis of ultrasonographic examinations performed during the last 5 years (2003-2007) in 10 548 consecutive patients undergoing cardiac catheterisation due to acute coronary syndromes or elective coronary angiography was performed. The relationship between mean monthly temperature, other factors and the rate of local bleeding complications was examined.


RESULTS
Mean number of treated patients was 2708 +/- 377/year (2113-3089), of whom 1692 +/- 362/year had coronary angiography and 1345 +/- 281/year had PCI. Yearly rate of all femoral bleeding complications was 3.0 +/- 0.5%. There were more haematomas than pseudoaneurysms: 2.2 +/- 0.4 vs. 0.8 +/- 0.1%, p < 0.0001. Higher mean monthly air temperatures were positively correlated with the number of complications (r = 0.11, p < 0.05), both in males and females (r = 0.13, p < 0.05). A positive correlation between number of haematomas and air temperature values was detected in women. Yearly rate of all vascular complications, haematomas and pseudoaneurysms was higher in women than in men 4.3 +/- 0.9 vs. 2.3 +/- 0.3% (p < 0.0001), 3.0 +/- 0.7 vs. 1.7 +/- 0.3% (p < 0.0001) and 1.3 +/- 0.2 vs. 0.6 +/- 0.1% (p < 0.0005) respectively. In spite of more aggressive antiplatelet therapy, higher clopidogrel loading doses and abciximab use introduced during the analysed period, the rate of local vascular bleeding complications did not increase.


CONCLUSIONS
High air temperature during the post-intervention period, besides female gender and advanced age, may be another risk factor for local bleeding complications. This risk remains low (3%), in spite of growing intensity of antiplatelet treatment.
Dabrowski
Rafał
R
2nd Department of Coronary Heart Disease, Institute of Cardiology, Warsaw, Poland. rdabrowski45@gmail.com
Sosnowski
Cezary
C
Kowalik
Ilona
I
Kraska
Alicja
A
Smolis-Bak
Edyta
E
Zera
Tymoteusz
T
Borowiec-Kocańda
Anna
A
Woźniak
Jacek
J
Szwed
Hanna
H
D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000401:mortality; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome; D014463:Ultrasonography