Prognostic value of bleeding after percutaneous coronary intervention in patients with diabetes.
OBJECTIVE
The aim of this study was to assess the impact of bleeding after percutaneous coronary intervention (PCI) on the outcome of patients with type 2 diabetes.


RESULTS
This study included 4,329 diabetic patients who underwent PCI. Bleeding was assessed using the Bleeding Academic Research Consortium criteria. The primary outcome was one-year mortality. Bleeding events occurred in 474 patients (10.9%). Access-site and non-access-site bleeds occurred in 274 patients (58%) and 200 patients (42%), respectively. Within the first year after PCI there were 198 deaths: 45 deaths (9.6%) among patients with bleeding and 153 deaths (4.0%) among patients without bleeding (adjusted hazard ratio=2.04 [95% confidence interval 1.38-3.00], p<0.001). There were 25 deaths (12.7%) among patients with non-access-site bleeding and 20 deaths (7.4%) among patients with access-site bleeding (odds ratio [OR]=3.45 [2.20-5.41], p<0.001 for non-access-site bleeding vs. no bleeding and OR=1.90 [1.17-3.01], p=0.008 for access-site bleeding vs. no bleeding). Bleeding improved the discriminatory power of the multivariable model for mortality prediction (p=0.002).


CONCLUSIONS
In patients with diabetes undergoing PCI, occurrence of bleeding within the first 30 days after PCI was associated with a significant increase in the risk of one-year mortality.
Deutsches Herzzentrum München, Munich, Germany.
Gjin
G
Ndrepepa
Stefanie
S
Schulz
Franz-Josef
FJ
Neumann
Karl-Ludwig
KL
Laugwitz
Gert
G
Richardt
Robert A
RA
Byrne
Anja
A
Pöhler
Adnan
A
Kastrati
Jürgen
J
Pache
D000077284:Abciximab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects*; D000991:Antithrombins / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D000077144:Clopidogrel; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000401:mortality; D006493:Heparin / Q000009:adverse effects; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000009:adverse effects; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011379:Prognosis; D016016:Proportional Hazards Models; D011994:Recombinant Proteins / Q000009:adverse effects; D012307:Risk Factors; D015607:Stents; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D000991:Antithrombins; D006629:Hirudins; D007140:Immunoglobulin Fab Fragments; D010446:Peptide Fragments; D010975:Platelet Aggregation Inhibitors; D011994:Recombinant Proteins; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin; C074619:bivalirudin; D000077284:Abciximab