title: Correlates of poor outcome among patients with bleeding after coronary interventions.
abstract: OBJECTIVE
  The objective of this study was to identify factors associated with the increased risk of mortality among patients with bleeding complications during percutaneous coronary intervention (PCI).
  
  
  METHODS
  The study included 1510 patients with periprocedural bleeding complications of the 14 180 patients undergoing PCI. Bleeding was defined and scaled according to the Bleeding Academic Research Consortium criteria. The main outcome was all-cause mortality at 1 year after PCI.
  
  
  RESULTS
  Of the 1510 patients with bleeding within the first 30 days of PCI, 104 patients (6.9%) died during the first year after PCI. One-year survival according to the Bleeding Academic Research Consortium classes was as follows: 96.4% (22 deaths) in class 1, 94.7% (12 deaths) in class 2, 91.0% (42 deaths) in class 3a, 85.4% (23 deaths) in class 3b, and 58.3% (five deaths) in class 3c (P<0.001). The Cox proportional hazards model identified bleeding severity [hazard ratio (HR)=1.55, 95% confidence interval 1.25-1.93 for one class increase in bleeding scale, P<0.001], bleeding site [HR=1.79 (1.18-2.71) for nonaccess vs. access site, P=0.006], elevated troponin levels [HR=1.66 (1.09-2.53), P=0.018], multivessel disease [HR=2.15 (1.01-4.56), P=0.047], C-reactive protein [HR=1.04 (1.01-1.06) for 5 mg/l increase, P=0.002], anemia [HR=2.27 (1.39-3.71) for 4 g/dl decrease in hemoglobin, P=0.001], and platelet count [HR=1.11 (1.02-1.21) for 50×10/l increase in platelet count, P=0.013] as independent associates of mortality. Age (P=0.072) and reduced estimated creatinine clearance (P=0.066) were close to reaching statistical significance as associates of mortality.
  
  
  CONCLUSIONS
  Among patients with peri-PCI bleeding, the characteristics of bleeding itself and the cardiovascular risk profile underlie the increased risk for poor outcome after PCI.
authors.affiliation: aDeutsches Herzzentrum, München b1.Medizinische Klinik rechts der Isar, Technische Universität cDZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Elena
authors.initials: E
authors.lastname: Guerra
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.forename: Petra
authors.initials: P
authors.lastname: Hoppmann
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers